THIS PAGE LISTS HUNDREDS OF STUDIES ABOUT DRUGS, EFFECTS, TREATMENTS, TRENDS - COLLECTED FOR A POSSIBLE UPDATE
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HEAVY DRINKING DULLS MIND EVEN AFTER YOU SOBER UPMemory, learning skills are hindered the next day, study findsBy
Randy Dotinga HealthDay ReporterFRIDAY, Nov. 19 (HealthDayNews) -- It's no secret a night of heavy drinking can leave
you with a parched mouth, a ferocious headache and an unsteady stomach the next morning.

But it can also make it tough to learn new information or recall things you already know, a new study says.

Researchers from Northern Ireland say they've shown that hangovers contribute to memory problems and delayed reaction
time, even many hours after last call.

The findings may sound obvious, and indeed they "confirm what a lot of people observe about how they function after a
night out drinking," said Dr. Robert Cloninger, a professor of psychiatry at Washington University Medical School who studies
the effects of alcohol.

What's different about the new findings is that the bodies of most of the study participants had processed all the booze
from the night before. Even after their blood-alcohol levels had returned to zero, they still had trouble with basic tasks.

"That's significant because it suggests that if you went out drinking and allowed enough time so that your blood-alcohol
concentration was at zero by the time you went to class the next day, you could still have difficulty learning new information,"
said alcohol researcher Aaron White, an assistant research professor of psychology at Duke University. "These findings suggest
that alcohol can affect your ability to learn long after the effects of the drug have worn off."

The researchers enlisted 33 women and 15 men, all "social drinkers," to take part in their study. The subjects underwent
memory and coordination testing the mornings after either abstaining or drinking their usual amount of alcohol between 10
p.m. and 2 a.m.

The participants were hardly light drinkers. The women, on average, drank 10.6 "units" per evening when they were allowed
to drink; the average for men was 10.5. A "unit" was defined as a glass of wine, a half-pint of beer or a "measure" of liquor.

The findings appear in the November/December issue of Alcohol and Alcoholism .

The morning after drinking, the subjects performed worse on some tests of memory and reaction time than those who didn't
drink, although being hung over didn't hurt the performance of the drinkers in all the tests.

As expected, the drinkers didn't feel great, either.

"Participants reported hangover effects as measured in terms of fatigue, physical discomfort and emotional disturbance,"
said study co-author Adele McKinney, a research assistant at the University of Ulster.

The study didn't speculate about how hangovers contribute to lower performance on mental tasks. However, Duke University's
White said hangovers have a lot to do with the fact that alcohol simply isn't good for the body.

"People feel sick the next day primarily because they've poisoned their bodies the night before with alcohol," White
said. "It's a poison, and it just so happens to be a poison that gives us a nice buzz. But you pay for it. The body must devote
energy to processing and removing it."

Even when no alcohol is left in the body, people are still plagued by aftereffects such as fatigue, nausea and dehydration,
he said. "All of that is going to make it harder for you to pay attention, to feel like learning and stay awake," he added.
"Those things are going to impair your function."

What to do? Of course, you could decide not to drink or at least not drink too much. Downing a glass of water or another
non-alcoholic beverage between drinks will slow drunkenness and combat dehydration, White suggested.

But if you do drink too much, the best thing to do the next morning is to take an aspirin, White said. And simply wait
for time to pass.

More information

For more about alcohol abuse, visit the National Institute on Alcohol Abuse and Alcoholism (www.niaaa.nih.gov target=new).

SAN DIEGO - You may have killed some brain cells last weekend, butdon't worry. More are on their way.

Every day hundreds of new nerve cells, or neurons, pop into existencein your overtaxed brain. They may not make up
for a lifetime of abuse,but they could help your brain in other ways, scientists say.

Newborn neurons may help you learn and remember better. They may fightbrain ailments such as addiction and depression;
antidepressants maywork partly because they trigger a flood of new neurons in the brain.

Scientists are unraveling the secrets of these baby neurons, hoping tolearn what makes a healthy brain.

New research shows that exercise stimulates the birth of new neurons -but only if the mouse being studied actually
wants to exercise. Otherfindings suggest that drinking alcohol prevents new neurons from beingborn. And Dallas researchers
have found that drugs such as morphinemess with newly created neurons, causing them to divide abnormally andalter
the brain.

These and other discoveries may one day help you take better care ofyour brain, scientists said last month in San
Diego at the annualmeeting of the Society for Neuroscience.

Researchers once thought that baby neurons could spring up only inbabies: A person got new neurons until the age
of 2 or 3; after that,the brain's neurons died off over the course of a lifetime. Even inthe healthiest person, tens
of thousands of neurons naturallyself-destruct every day.

"If we were to hear all the neurons in this room dying,"neuroscientist Theodore Palmer told a standing-room-only
crowd at themeeting, "it would sound like popcorn on a massive scale."

But five years ago, scientists discovered that the adult human braincould also make new neurons, a process known
as neurogenesis.

Neurons are born much more slowly than others die, and not all of thenew ones survive. But scientists think that
adult neurogenesis couldplay a major role in brain health - if only they could figure out whatthat role is.

Newborn neurons inhabit at least two places in the brain - theolfactory bulb, which is involved in smell, and the
hippocampus, atiny seahorse-shaped structure that is important in memory. Scientistsfocus in particular on the hippocampus
because it's linked to so manycrucial brain functions.

For instance, rats with lots of new hippocampal neurons do better atlearning new mazes than rats without, said Amelia
Eisch, an assistantprofessor of psychiatry at the University of Texas SouthwesternMedical Center at Dallas.

"New neurons maybe equal new memory," she said. But the story is morecomplicated than that.

"It sounds simple: more neurons good, fewer neurons bad," Eisch said."That's a good place to start, but it's a lousy
place to finish."

For instance, rates of neurogenesis go up after a stroke. But no onewants to have a stroke just to increase brain
cells.

Rather, scientists are working to uncover what causes neurogenesis.

One factor could be exercise. Earlier research had shown that miceallowed to run as much as they wanted on exercise
wheels had higherrates of neurogenesis. While training for a marathon, neuroscientistLeigh Leasure of the University
of Houston decided to study whetherinvoluntary exercise has the same effect.

She had one group of mice run freely, trapped another group on atreadmill with a sponge at the back to keep them
moving, and let athird group remain sedentary. After three weeks, the most new neuronsappeared in the brains of mice
that exercised voluntarily.

The study, although done in mice, could have implications for humanstrying to exercise, Leasure said.

"Maybe what's important is for people to choose something they enjoy,not something that they are not really excited
about doing and have toforce themselves to engage in," she said. "Maybe it's walking withyour granddaughter after
dinner instead of slogging along on thetreadmill."

But don't have too much wine with that dinner. New alcohol studiessuggest that drinking hampers neurogenesis.

At the University of North Carolina, Kimberly Nixon and her colleagueshave been studying what happens to the brains
of rats whose bloodalcohol level reaches 0.30 percent and higher. "We call it the'college football weekend' model,"
she said.

Even a single massive dose kept new neurons from forming nearly amonth later, the scientists found.

But there is some good news: Avoiding alcohol allows your brain torecover somewhat. After just a week of abstinence,
rats that had beendependent on alcohol doubled the rate at which new brain cells wereborn, Nixon and Fulton Crews
reported in the Oct. 27 issue of TheJournal of Neuroscience.

Using drugs can also seriously affect neurogenesis, Eisch has foundwith her UT Southwestern colleague Chitra Mandyam.

Morphine, heroin and nicotine cause fewer new cells to be born,Mandyam reported at the San Diego meeting. And newborn
neurons in thebrains of morphine-addicted mice divide abnormally.

The work helps clarify how morphine affects the brain and may one daylead to new treatments for addiction, Eisch
said.

To find new neurons, scientists inject animals with a chemical thatmarks dividing cells. As seen through a microscope,
the newborn cellslight up among a sea of older, dimmer neurons.

Scientists want to improve that technology to better understand howand when new neurons are born. More important,
they need to learn whatthe new neurons do once they get incorporated in the brain, Eischsaid.

One day, new treatments for brain disorders could spring from basicresearch into understanding why neurons appear
where they do, and whatthey do once they get there, Eisch said.

"If you're the right neuron in the right place, you can make a worldof difference," she said.

University of Vermont

Burning anxiety: New treatment targets smokers with panic disorder

Not everyone who tries to quit the habit on the Great American Smokeout Nov. 18 will have the same odds of success.
The 2.4 million Americans who have panic disorders not only smoke at a disproportionately high rate--about 40 percent
vs. 24 percent of the general population--they also have a harder time quitting and relapse more often. Another 5 percent
of American smokers--2.4 million more people--may develop panic-related symptoms or even panic disorder when they
try to quit. Interventions such as nicotine replacement therapy and counseling don't address their symptoms, but new
programs pioneered by University of Vermont psychologists are offering hope.

Research suggesting that smoking often precedes panic disorder and may increase risks of developing the malady led
Michael Zvolensky, assistant professor of psychology and director of UVM's Anxiety Health and Research Laboratory,
to pioneer new prevention and treatment programs now being duplicated at other institutions. Participants learn to deal
with their panic-related symptoms through gradual exposure, coping strategies and mentally correcting illogical fears.

"Once conditioning has happened, you can't undo it," says Zvolensky, who initiated the programs. "We don't try to
remove panic-related symptoms, but we offer an alternative model to teach people to tolerate and/or alleviate symptoms."

Smokers with panic disorder "appear to be super-motivated to quit," says Zvolensky, "but they also seem to have a
harder time quitting, and are more likely to relapse." That's not hopeful news, considering that more than 90 percent
of smokers in the general population who quit on their own and up to 85 percent who attend traditional treatment programs
relapse within a year.

Zvolensky believes that mental health professionals have largely ignored cigarette smoking. Little is understood
of how smoking relates to anxiety disorders other than panic disorder, but studies indicate that a history of heavy
smoking may increase the chance of developing a variety of emotional disorders.

As a result of his research in the United States and Russia, Zvolensky and his team are currently evaluating a brief
prevention program and a 16-week treatment protocol that targets smokers who are vulnerable to panic psychology. By
inducing panic symptoms through such methods as having patients hyperventilate or breathe CO2-enriched air, smokers learn
to tolerate panic symptoms and react differently to those sensations. For instance, they learn to recognize that a
racing heartbeat isn't the onset of a heart attack.

Citizens of Nova Scotia are trying out Zvolensky's treatment model through a collaboration with the Psychiatry Department
at Dalhousie University, and laboratories elsewhere are duplicating his studies, which have been documented in more
than 30 articles in peer-reviewed journals such as Addictive Behaviors and Clinical Psychology Review. Although long-term
data are not yet available, Zvolensky hopes his research will lead to targeted, more effective methods to help people
with panic sensitivities quit the habit - and in some cases, help them to avoid developing the disorder in the first
place.

ECSTASY LINKED TO MEMORY LOSS3.10.2004. 13:37:17People who swallow the party drug ecstasy may forget more
than just theirinhibitions, with new research indicating memory damage.

A study by a clinical psychology PhD student says the popular drug affectsthe memory, especially in high pressure
situations.

The research, conducted over four years, compares the average memoryperformance of three groups of about 30 participants.

They were ecstasy users who hadn't used the drug in two weeks, drug userswho don't take ecstasy and people who don't
use illicit drugs.

Researcher John Brown, from the Australian National University, says therewere small deficits in the average memory
performance of ecstasy userscompared with both other groups.

But he says another test found relatively large memory deficits.

SOURCE: Radio News

New study shows hope for treating inhalant abuse

GVG may reduce addictive effects of 'huffing'

UPTON, N.Y. -- A new study by scientists at the U.S. Department of Energy'sBrookhaven National Laboratory suggests
that vigabatrin (a.k.a. gammavinyl-GABA or GVG) may block the addictive effects of toluene, a substancefound in many
household products commonly used as inhalants. These resultsbroaden the promise of GVG as a potential treatment for a
variety ofaddictions. The study will be published in the December 1, 2004 issue ofSynapse, available online September
30.

Inhalant abuse or "huffing" continues to grow as a serious health problem:According to the National Institute on
Drug Abuse, the number of newinhalant users increased from 627,000 in 1994 to 1.2 million in 2000. Thechronic use
of inhalants has been associated with heart, liver, kidney, andbrain damage -- and can even result in sudden death.

The Brookhaven Lab study demonstrates that animals previously trained toexpect toluene in a given location spent
far less time "seeking" toluene inthat location after being treated with GVG than animals treated with aplacebo. This
elimination of conditioned place preference -- a model ofcraving in which animals develop a preference for a place where
they havepreviously had access to a drug, even when the drug is absent -- is similarto the aversion seen in Brookhaven's
earlier studies of GVG with nicotineand heroin.

"The findings of this study extend the potential value of GVG to treataddiction," says Stephen Dewey, the Brookhaven
Lab neuroanatomist who ledthe study. "More importantly, our results show promise in treating inhalantabuse as it continues
to grow as a problem among adolescents." There arecurrently no pharmaceutical treatments for inhalant abuse.

The study was conducted by putting rats through a series of conditioningtests. The tests were intended to condition
the animals to learn whichchambers of a three-chambered apparatus contained toluene vapors. On thefinal day of the
study, scientists randomly administered either saline orGVG to the rats one hour before the testing. They then gave the
rats freeaccess to the chambers with no toluene present while monitoring theanimals' behavior.

Researchers found that animals treated with GVG spent 80 seconds on theside of the chamber where they had previously
received toluene as comparedto the saline-treated animals, which spent 349 seconds in the "toluene"chamber. "GVG significantly
blocked toluene-seeking behavior in theserats," Dewey said.

Earlier research at Brookhaven Lab demonstrated the addictive nature ofinhalants. A team led by Dewey found that
toluene elevates dopamine in thesame regions of the brain as other addictive drugs, such as cocaine. Theneurotransmitter
dopamine is associated with the activation of pleasure andreward circuits in the brain.

Inhalant abuse is among the most common forms of drug abuse, particularlyamong pre- and early adolescents, who inhale
or "huff" chemical vaporsfound in many common household products that are not generally thought ofas drugs. Seventy-one
percent of inhalant users are 12 to 25 year olds,according to the 2002 National Survey on Drug Use and Health performed
bythe U.S. Substance Abuse & Mental Health Services Administration.

Stephen Dewey and Jonathan Brodie, a psychiatrist at the New YorkUniversity School of Medicine, have collaborated
at Brookhaven Lab on alarge body of preclinical research on GVG as a potential treatment foraddiction, and on two
small-scale trials of GVG in Mexico [one publishedhttp://www.bnl.gov/bnlweb/pubaf/pr/2003/bnlpr092203a.asp, one yet-to-bepublished]. Results from the preclinical and early clinical trials showthat GVG holds promise as a
treatment for addiction to a variety of abuseddrugs (see: http://www.bnl.gov/pet/GVG/default.asp).

In October 2002, Catalyst Pharmaceutical Partners of Coral Gables, Florida(http://www.catalystpharma.com), received an exclusive worldwide licensefrom Brookhaven Science Associates, operator of Brookhaven NationalLaboratory,
for the use of the drug GVG for its application in treatingdrug addiction.

This work was funded by the Office of Biological and Environmental Researchwithin the U.S. Department of Energy's
Office of Science and the NationalInstitute on Drug Abuse.

WASHINGTON (Reuters) - College students may down as many as 24 alcoholic drinks in a row when they party -- far more
than any previous studies have indicated, U.S. researchers said on Wednesday.The study by the Prevention Research Center
of the Pacific Institute for Research and Evaluation shows that university students, especially young men, may be drinking
even more heavily, and dangerously, than parents and educators feared.

Most research defines "binge drinking" as having five or more drinks in a row, without counting how far past five
the drinkers go.

The Berkeley, California-based nonprofit health research institute found that many of the 1,000 male college drinkers
surveyed said they had 24 or more drinks in a row.

"These are levels of drinking at which most men will have passed out or become comatose," said Paul Gruenewald, who
led the study.

"These are levels at which drinkers are at risk for the very serious problems posed by peak drinking, including alcohol
poisoning," Gruenewald added in a statement.

The study found that about 10 percent of the time, the drinkers had 12 or more drinks during a single session.

"When you see just how much some students may drink, it's easier to understand how these young people may suffer
from many alcohol-related accidents and injuries, some as simple as falling out of a dormitory window."

The study was funded by the National Institute on Alcohol Abuse and Alcoholism, one of the National Institutes of
Health. Women were not included in the study.

Fewer U.S. teens are using marijuana, Ecstasy or LSD but more are bingeing on alcohol and abusing prescription
drugs, according to an annual government survey released Thursday.

While overall rates of illegal drug use have not changed, the use of some drugs decreased sharply, the 2003 National
Survey on Drug Use and Health found.

Among youths aged 12 to 17, 41 percent fewer said they had used Ecstasy in the past month and 54 percent fewer said
they had taken LSD. The survey found a 5 percent decline in the number of teens who had ever used marijuana.

The Health and Human Services Department quickly credited an advertising and education campaign. "It is encouraging
news that more American youths are getting the message that drugs are dangerous, including marijuana," HHS Secretary Tommy
Thompson said in a statement.

The annual survey by the Substance Abuse and Mental Health Services Administration found that 19.5 million Americans
aged 12 and older, or 8 percent of that population, currently use illicit drugs.

MARIJUANA STILL NO. 1 ILLEGAL DRUGMarijuana continues to be the most commonly used illegal drug, with 14.6 million
current users or 6.2 percent of the population. The survey found an estimated 2.6 million new marijuana users in 2002,
about two-thirds of them under the age of 18.

The Marijuana Policy Project, which supports the legalization of marijuana, said the numbers showed government policies
have failed.

"When you clear away the spin and look at the long-term trends, the real story is that three decades of drug use
surveys show that marijuana prohibition has completely failed to keep young people from using marijuana," said Steve Fox,
director of government relations for the group.

The SAMHSA survey found the numbers of binge and heavy drinkers did not change between 2002 and 2003. About 54 million
Americans 12 and older admitted to binge drinking, defined as having five or more drinks in a row, in the month before
the survey.

Young adults aged 18 to 25 were the likeliest binge and heavy drinkers.

An estimated 13.6 percent of people 12 or older -- 32 million people -- admitted to driving under the influence of
alcohol at least once in the 12 months prior to the interviews, down from 14.2 percent in 2002.

Misuse of three painkillers -- Vicodin, Lortab and Lorcet -- rose from 13.1 million to 15.7 million. Similarly the
number of people who said they had ever misused narcotic painkillers such as Percocet, Percodan, or Tylox rose from 13.1
million to 15.7 million people.

An estimated 2.3 million people said they used cocaine in 2003, 604,000 of whom used crack. One million used hallucinogens
including LSD, PCP and Ecstasy while an estimated 119,000 people used heroin. These numbers were all similar to 2002
rates.

The 2003 survey is based on in-person interviews with people aged 12 and older but it does not include active duty
military personnel, the homeless, prisoners or others in institutions.

Drug court programs get $42 millionUnited Press International - September 08, 2004 WASHINGTON, Sep 08, 2004 (United
Press International via COMTEX) -- The Justice Department said Wednesday it has awarded more than $18 million to continue
special drug courts in 42 states.

The courts "integrate judicial supervision -- including sanctions with substance abuse treatment, mandatory drug
testing and transitional services to help non-violent, substance-abusing offenders break free of crime and drug addiction,"
the department said in its announcement.

The majority of the 31 drug court grants in 2004 ($13.16 million), were awarded to jurisdictions for drug court implementation.
Another 30 grants ($4.97 million) were awarded to enhance or expand existing drug courts.

Ten jurisdictions received more than $3.85 million to create family drug courts, the department said.

Grants for up to $400,000 were available to implement drug courts and grants for up to $200,000 were available to
enhance existing drug courts.

A new report on drug courts, "Painting the Current Picture: A National Report Card on Drug Courts and Other Problem
Solving Court Programs," is accessible at ojp.usdoj.gov.

Early Puberty Linked to Early Substance AbuseStudy found those who matured physically at younger age more likely
to experiment

By Amanda GardnerHealthDay Reporter

TUESDAY, Sept. 7 (HealthDayNews) -- Kids who enter puberty early are more likely to use and abuse tobacco, alcohol
and marijuana than those who physically mature later, mostly because their window of opportunity for experimentation is
wider.

Early puberty showed itself to be more important than age or school grade in influencing this type of behavior, claims
a study in the September issue of Pediatrics.

"Puberty marks the beginning of adolescence and the beginning of a much higher risk period for substance use and
abuse. For the individual, this is true whether puberty occurs early or late," explained study author Dr. George C. Patton.
"Where puberty occurs early that individual enters the higher risk period at an earlier point and hence the risk period
is extended downwards, widened if you like."

Patton is professor of adolescent health at the Centre for Adolescent Health at Murdoch Children's Research Institute
in Melbourne, Australia.

The findings raise the possibility that anti-substance abuse messages geared to younger kids might be helpful.

"Teens who develop early might be a risk group that is in need of more attention than we're currently giving," said
Suzanne Ryan, a research associate with Child Trends, a nonprofit, nonpartisan research group in Washington, D.C. "There
might need to be more vigilance by parents that if teens are developing earlier, just to be aware that they might be facing
a set of problems in terms of age this society doesn't think they're faced with."

This study, which was done in conjunction with researchers at the University of Washington in Seattle, surveyed 5,769
10-to-15-year-olds in both Washington State and in Victoria, Australia. Participants completed questionnaires about use
of tobacco, alcohol and marijuana. They also were asked to rate their own biological development by providing information
on breast and pubic hair development. After completing the survey, students in Washington received $10 in compensation
while students in Victoria received a pocket calculator.

The odds that a student had used a substance in his or her lifetime was almost twice as high in mid-puberty and three
times as high in late puberty. Recent substance abuse was about 40 percent higher for those in mid-puberty and more than
twice as high for those in late puberty, the survey found.

The odds of substance abuse were twice as high for those in mid-puberty and more than three times as high in late
puberty.

Those in the later stages of puberty were more likely to report having friends who were substance users, a relationship
that partly accounted for substance abuse.

The road to substance use and abuse seemed to be influenced primarily by "the tendency of the mature youngster to
seek out those who were substance users as friends," Patton said. "That was the main change affecting substance use. That
may have something to do with substance users being the 'cool' group to belong to." Other factors, such as a more distant
and conflicted relationship with parents, also increased the risk for substance use.

But if knowledge is power, this information should give parents and researchers more tools for prevention.

"First and foremost, the findings are telling us about the timing for investment in prevention of substance use.
Late childhood through to the mid-teens is a crucial phase for the timing," Patton said. "The focus we have often had
has been on health education of youth, but this study tells us something about why this is unlikely to work in a setting
where substance use is common. The strategies that are likely to be most effective are those that restrict access to
substance use within the younger teenage group. [This might include] enforcement of existing legal sanctions against use
and sale of substances to this age group and clear and communicated community standards around substance use."

The new data show that the number of adolescents ages 12 to 17admitted to substance abuse treatment increased 65
percent between1992 and 2002. In 1992, adolescents represented 6 percent of alltreatment admissions. By 2002, this
proportion had grown to 9 percent.This report expands upon data published in May in the "TreatmentEpisode Data Set
(TEDS) Highlights 2002."

The increase in substance abuse treatment admissions among 12 to 17year olds was largely due to the increase in the
number of admissionsin this age group that reported marijuana as their primary drug ofabuse. Between 1992 and 2002,
the number of adolescent treatmentadmissions for primary marijuana abuse increased 350 percent. In 1992,23 percent
of all adolescent admissions were for primary marijuanaabuse. By 2002, 63 percent of adolescent admissions reported marijuanaas
their primary drug.

"The youthfulness of people admitted for marijuana use shows that weneed to work harder to get the message out that
marijuana is adangerous, addictive substance," SAMHSA Administrator Charles Curiesaid. "All Americans must begin to
confront drug use -- and drug users-- honestly and directly. We must discourage our youngsters from usingdrugs and
provide those in need an opportunity for recovery byencouraging them to enter and remain in drug treatment."

Forty-eight percent of all adolescent treatment admissions in 2002involved the use of both alcohol and marijuana.
Admissions involvingthese two substances increased by 86 percent between 1992 and 2002.

In 2002, more than half (53 percent) of adolescent admissions werereferred to treatment through the criminal justice
system. Seventeenpercent were self- or individual referrals, and 11 percent werereferred through schools.

The TEDS report provides detailed data on admissions to substanceabuse treatment for all age groups. The 2002 data
show that polydrugabuse (abuse of more than one substance) was more common among TEDSadmissions than was the abuse
of a single substance. Polydrug abusewas reported by 55 percent of all admissions for substance abusetreatment in
2002. Alcohol, marijuana and cocaine were the mostcommonly reported secondary substances. For marijuana and cocaine,more
admissions reported these as secondary substances than as primarysubstances.

This new report provides information on the demographic and substanceabuse characteristics of the 1.9 million annual
admissions totreatment for abuse of alcohol and drugs in facilities that report toindividual state administrative
data systems. The report also includesdata by state and state rates.

SAMHSA, a public health agency within the U.S. Department of Healthand Human Services, is the lead federal agency
for improving thequality and availability of substance abuse prevention, addictiontreatment and mental health services
in the United States.

According to national surveys, nearly a third of Americans consume more than the FDA-recommended two drinks a day.
In the last two decades, treatment professionals have realized that reaching these potential alcohol abusers is important.
The August issue of the Harvard Mental Health Letter examines brief interventions for this large segment of the population.

Known as problem drinkers, this group probably accounts for most of the problems caused by alcohol, including family
problems, accidents, illness, and injuries. They rarely think of themselves as alcoholics or seek standard treatment for
alcoholism. However, recent studies suggest that a little advice and encouragement can help problem drinkers cut down
or eliminate their drinking. An estimated 75% of alcohol abusers recover without professional treatment or 12-step
groups.

The source of advice could be a physician, counselor, or lay person who is knowledgeable about alcohol. The helper
can ask about alcohol consumption and compare it to the norm. Too often, people define "moderation" as the amount they
themselves drink. The helper can provide a self-help manual, give a brief talk about the consequences of alcohol abuse,
suggest choosing a goal and keeping records of drinking patterns, and make professional treatment referrals if necessary.

Intervention can begin by screening large numbers of people for alcohol problems. The August issue of the Harvard
Mental Health Letter provides the following widely used questionnaire entitled CAGE (Cut down, Annoyed, Guilty, Eye-opener)
that has been estimated to identify 60-70% of alcohol abusers. A person who answers "yes" to even one of these questions
may have a problem that a closer examination will reveal.

* Have you ever felt that you should cut down?

* Have people annoyed you by criticizing your drinking?

* Have you ever felt guilty about your drinking?

* Have you ever had a drink first thing in the morning to steady your

nerves or get rid of a hangover?

FDA Approves New Treatment for Alcoholism

Associated Press - July 30, 2004 WASHINGTON (AP) - The government approved the first new drug to treat alcohol abuse
in a decade on Thursday, a medicine called Campral that promises to help ward off relapses.

Campral, known chemically as acamprosate, isn't for patients who are actively drinking at the start of treatment
or who abuse other substances in addition to alcohol, the Food and Drug Administration warned.

Exactly how Campral works isn't fully understood. But it is thought to somehow ease alcoholism withdrawal symptoms
by normalizing abnormalities in two brain chemical systems.

In a study comparing Campral to a dummy pill, more of the people using Campral were continuously abstinent throughout
their alcohol-abuse treatment, FDA said - although officials late Thursday couldn't provide the numbers to show how big
the difference was.

Most common side effects were headache, diarrhea, flatulence and nausea, FDA said.

Campral, made by France's Lipha Pharmaceuticals, has been widely used in Europe for years. In the United States,
there are two other FDA-approved drugs for alcohol abuse treatment: Antabuse, which reacts with alcohol to make the drinker
violently ill, and naltrexone, which blocks brains chemicals that make alcoholics feel good after a drink.

Campral will be distributed in the United States by Forest Laboratories, which did not immediately reveal a price.

TESTS DETECT SURGE IN METHAMPHETAMINE USEJuly 23, 2004NEW YORK (AP) - Often made on the cheap in simple home-based
labs,methamphetamine is fast finding its way into the workplace, a newreport indicates.

Employers who screen job applicants and workers for drugs saw thenumber testing positive for methamphetamine surge
68 percent lastyear, according to Quest Diagnostics Inc., the country's largesttesting company, and usage is likely
to continue increasing as thepotent stimulant spreads to the eastern U.S.

The report - tallying the results of more than 7 million workplacedrug tests performed last year by Teterboro, N.J.-based
Quest - showsthe methamphetamine positive rate jumped, along with a smaller rise inpositives for opiates like heroin,
even as the overall number ofworkers failing tests stayed nearly unchanged at 4.5 percent.

``These increases that we're seeing are the largest increases of anydrug or drug class for as long as we've been
tracking the individualcategories'' of drug tests, said Barry Sample, director of science andtechnology for Quest's
workplace drug testing business.

Quest has been conducting its annual survey since 1988, but has onlybroken it down by drug category and type of worker
since 1997.

The surge in the use of amphetamines, a crystalline stimulant oftencalled ``meth'' or ``ice,'' has prompted some
states to try to limitsales of the decongestant pseudoephedrine commonly used to make it.While big labs, most in California,
continue to supply most of theillegal methamphetamine consumed in the U.S., much of the growth hasbeen fed by small,
home labs.

Last year, the Drug Enforcement Administration shut down 10,061 smallmeth labs, up from 8,063 in 2002. ``Clearly
it's emerged and is stillemerging as a serious problem,'' said Ed Childress, a DEA spokesman.

The number of workers and job candidates testing positive formethamphetamine remains small compared to marijuana,
by far thebiggest reason that people fail employer drug screenings, the Questfigures show. About 3 of every 1,000
workers now test positive formeth, compared to about 3 of every 100 workers testing positive formarijuana.

But while marijuana positives have stayed stable, amphetaminedetection is soaring in the general work force. That
contrasts withairline pilots, workers in nuclear plants and others whose tests arerequired by the government, for
whom positive meth rates haveincreased only slightly.

In the general work force, though, usage appears to be rising at aneven faster rate than in the past few years, when
annual increases inthe number of positive drug tests ranged from 14 to 17 percent.

Employers who do screenings saw a 44 percent increase in positives foramphetamines, the category of drugs that includes
methamphetamines.Amphetamines now account for about 9.3 percent of all positive tests,more than double the rate in
1999.

Methamphetamine production and usage has its roots in southernCalifornia and was long most prevalent in western states.
But DEAstatistics and Quest testing data shows it has spread to the middleand eastern portions of the country.

Quest found the number of workers testing positive for the drug hasincreased sharply in southeastern states like
Georgia and Alabama. Ofthe small labs broken up by the DEA last year, the largest number werein Missouri, with states
like Tennessee and Arkansas also hotbeds ofproduction.

In addition to the rise in meth usage, Quest found that positive testsfor opiates - including both heroin and the
painkiller morphine, whichis contained in many prescription drugs - are also rising, up 25percent in 2003 for the
general work force.

Overall, the share of workers testing positive for all types of drugsremained nearly unchanged - rising to 4.5 percent
from 4.4 percent.That is much lower than the 11 to almost 14 percent rate in the late1980s, when employer drug tests
were not as common. The number ofworkers testing positive has fluctuated below 5 percent for the lastsix years.

Marijuana accounted for the largest share of the positive tests, with2.96 percent of all workers testing positive
for the drug. Cocaine wasthe next leading cause of positive tests, with 0.74 percent of workerstesting positive, Quest
figures showed. Both results varied littlefrom 2002.

AMPHETAMINES DULL YOUR DESIRE TO WINWEDNESDAY, July 21 (HealthDayNews) -- You really don't care if you winor
you lose when you're on amphetamines, researchers at StanfordUniversity have found.

Doctors discovered that people on dextroamphetamines were less likelyto get excited at the prospect of a cash reward
for successfullycompleting a task.

The subjects also were less likely to be upset at the possibility oflosing, leading researchers to theorize that
such drugs might help"maintain motivation even in the face of adversity."

Magnetic resonance imaging (MRI) scans of the subjects' brains duringthe task revealed a selective damping of peak
activity in a region ofthe cortex known as the ventral striatum. Prior study has shown thatregion is activated by
anticipation of reward.

The subjects also were asked to rate their feelings of happiness,excitement, unhappiness, and fearfulness after each
task.

The study appears in the July 22 issue of Neuron .

-- Dennis Thompson

SOURCES: Neuron , news release, July 21, 2004

July 20, 2004THIS IS YOUR BRAIN ON METH: A 'FOREST FIRE' OF DAMAGEBy SANDRA BLAKESLEE NY TimesPeople
who do not want to wait for old age to shrink their brains andbring on memory loss now have a quicker alternative - abusemethamphetamine
for a decade or so and watch the brain cells vanishinto the night.

The first high-resolution M.R.I. study of methamphetamine addictsshows "a forest fire of brain damage," said Dr.
Paul Thompson, anexpert on brain mapping at the University of California, Los Angeles."We expected some brain changes
but didn't expect so much tissue to bedestroyed."

The image, published in the June 30 issue of The Journal ofNeuroscience, shows the brain's surface and deeper limbic
system. Redareas show the greatest tissue loss.

The limbic region, involved in drug craving, reward, mood and emotion,lost 11 percent of its tissue. "The cells are
dead and gone," Dr.Thompson said. Addicts were depressed, anxious and unable toconcentrate.

The brain's center for making new memories, the hippocampus, lost 8percent of its tissue, comparable to the brain
deficits in earlyAlzheimer's. The methamphetamine addicts fared significantly worse onmemory tests than healthy people
the same age.

The study examined 22 people in their 30's who had usedmethamphetamine for 10 years, mostly by smoking it, and 21
controlsmatched for age. On average, the addicts used an average of four gramsa week and said they had been high on
19 of the 30 days before thestudy began.

Methamphetamine is an addictive stimulant made in clandestinelaboratories nationwide. When taken by mouth, snorted,
injected orsmoked, it produces intense pleasure by releasing the brain's rewardchemical, dopamine. With chronic use,
the brains that overstimulatedopamine and another brain chemical, serotonin, are permanentlycompromised.

The study held one other surprise, Dr. Thompson said: white matter,composed of nerve fibers that connect different
areas, was severelyinflamed, making the addicts' brains 10 percent larger than normal."This was shocking," he said.
But there was one piece of good news:the white matter was not dead. With abstinence, it might recover.

STRONGER POT MAY MAKE REEFER MADNESS REAL, U.S. FEARSMon Jul 19, 2004By Maggie Fox, Health and Science CorrespondentWASHINGTON
(Reuters) - Alarmed by reports that marijuana is becomingmore potent than ever and that children are trying it at younger
andyounger ages, U.S. officials are changing their drug policies.

Pot is no longer the gentle weed of the 1960s and may pose a greaterthreat than cocaine or even heroin because so
many more people use it.So officials at the National Institutes of Health and at the WhiteHouse are hoping to shift
some of the focus in research andenforcement from "hard" drugs such as cocaine and heroin to marijuana.

While drug use overall is falling among children and teens, theofficials worry that the children who are trying pot
are doing so atever-younger ages, when their brains and bodies are vulnerable todangerous side effects.

"Most people have been led to believe that marijuana is a soft drug,not a drug that causes serious problems," John
Walters, head of theWhite House Office of National Drug Control Policy, said in aninterview.

"(But) marijuana today is a much more serious problem than the vastmajority of Americans understand. If you told
people that one in fiveof 12- to 17-year-olds who ever used marijuana in their lives needtreatment, I don't think
people would remotely understand it."

JUMP IN POT-RELATED DETOX

The number of children and teen-agers in treatment for marijuanadependence and abuse has jumped 142 percent since
1992, the NationalCenter on Addiction and Substance Abuse at Columbia Universityreported in April.

According to the report, children and teens are three times morelikely to be in treatment for marijuana abuse than
for alcohol, andsix times likelier to be in treatment for marijuana than for all otherillegal drugs combined.

And it found the age of youths using marijuana is falling. The teensaged 12 to 17 said on average they started trying
marijuana at 13-1/2.The same survey found that adults aged 18 to 25 had first tried it at16.

For National Institute on Drug Abuse director Dr. Nora Volkow thefinal straw was a report her institute published
in May in the Journalof the American Medical Association showing the steady growth in thepotency of cannabis seized
in raids.

According to the University of Mississippi's Marijuana PotencyProject, average levels of THC, the active ingredient
in marijuana,rose steadily from 3.5 percent in 1988 to more than 7 percent in 2003.

Volkow said many studies have shown the brain has its own so-calledendogenous cannabinoids. These molecules are
similar in structure tothe active ingredients in marijuana and are involved in a range ofactivities and emotions ranging
from eye function to pain regulationand anxiety.

The cannabinoids in marijuana may use these ready-made doorways intobrain cells and this is why they cause a high
and reduce painsensations. But Volkow believes the effects may go beyond the generalfeeling of well-being that most
marijuana users seek.

"I would predict that stronger pot makes the brain less likely torespond to endogenous cannabinoids," Volkow said
in an interview. Theeffects could be especially marked in young brains still growing andlearning how to respond to
stimuli, she said.

While the research so far is inconclusive, Volkow believes thatcannabinoids affect the developing brain and that
stronger pot,combined with earlier use, could make children and teens anxious,unmotivated or perhaps even psychotic.

As an analogy, Volkow said opiate addicts are more sensitive to pain,as their overuse of drugs have raised the threshold
at which the bodyresponds and their own bodies produce fewer natural opiates.

NIDA is seeking proposals from researchers who want to investigatesuch possibilities for cannabis, she said.

Proponents of legalizing marijuana disagree with the official line.Krissy Oechslin of the Marijuana Policy Project
disputes the findingthat cannabis products are stronger.

"They make it sound like the THC levels in marijuana were almostnonexistent, but no one would have smoked it then
if that was true,"she said.

"And there's evidence that the stronger the THC, the less of it aperson smokes. I don't want to say it's good for
you, but I'll say(more potent marijuana) is less bad for you."

While Walters stresses that drug abusers are patients and notcriminals, he hopes to crack down more on producers.
And he says,there is a way to go in getting cooperation from local law enforcementofficials. "For many in enforcement,
marijuana is still 'kiddiedope'," Walters said.

Walters is quick to stress he does not want to overreact.

"We shouldn't be victims of reefer madness," he said, referring to the1930s propaganda film "Reefer Madness" that
became a 1970s cultclassic for its over-the-top scenes of marijuana turning teens intohomicidal maniacs.

'Crack babies' do better when placed with non-family caregiversEver since the epidemic of cocaine and crack use that
began in the1980s, researchers and doctors have been concerned about thedevelopment of children born to women who
used cocaine during theirpregnancy.

Initially, research focused on the potential negative impacts of thedrug itself, treating other factors associated
with maternal drug useas interfering. However, as researchers accumulated more information,many concluded that focusing
on the direct effect of the drug didn'tprovide a complete picture. In fact, in a letter to the editor of TheNew York
Times on Nov. 28, 2003, 28 leading researchers in the fieldquestioned whether the widely reported "crack baby" syndrome
evenexists.

In contrast to the lack of evidence regarding the toxic nature ofcocaine itself on the developing fetus, the negative
effect ofcocaine use on the quality of care parents provide to their youngchildren has been consistently documented.
Thus, we studied how thetype of care provided to toddlers who experienced prenatal cocaineexposure affected their
development.

We followed 83 cocaine-exposed and 63 non-exposed children and theircaregivers from birth until the children turned
2. By that age, 49 ofthe cocaine-exposed children remained with their parents while 34were cared for by other adults.
About half of the 34 children innon-parental care were cared for by relatives (kin care) and the restby unrelated
individuals.

We found that prenatal drug exposure was not directly related to thechildren's developmental outcome at age 2. However,
we found thatchildren in non-parental care, especially those in the care of peoplewho were not relatives, had better
environments than those cared forby their parents and performed better in several developmental areas.

This improved performance existed despite the fact that thesechildren experienced more problems at birth than the
children whoremained with their mothers, including prematurity, and were born tomothers who were heavier cocaine users.

These results suggest that many of the negative outcomes observed inchildren of cocaine users may result from the
quality of caregivingduring infancy rather than from the direct effects of the drug inutero.

If the environment is, in fact, more important in determining childdevelopmental outcomes than prenatal cocaine exposure,
thendevelopmental problems could be prevented and treated more easily.For instance, support could be provided either
through directintervention with children, by supporting women in their recoveryfrom substance abuse, and/or in helping
mothers improve theirparenting skills. Finally, our study suggests that "kin" caregiversof cocaine-exposed infants
and toddlers may also need support andhelp with parenting.###

SUBSTANCE ABUSE LINKED TO 1/4 OF VIOLENT CRIMESFri May 21, 2004By Patricia ReaneyLONDON (Reuters) - People
with serious drug and alcohol abuse problemsare linked to about a quarter of all violent crimes but many could beavoided
with better treatment, scientists said on Friday.

They found that 16 percent of crimes such as murder, robbery, assaultand rape in Sweden between 1988-2000 were committed
by people who hadbeen discharged from hospital for alcohol misuse and 10 percent wereassociated with drug abusers.

"It is likely you will find the same sort of figures in Western Europeand North America," Seena Fazel, of the University
of Oxford, said inan interview.

Fazel and Martin Grann, of the Karolinska Institute in Stockholm,studied the country's national crime register and
compared it withhospital discharges of people diagnosed with alcohol and drug misuseand psychoses.

Few countries, apart from Scandinavian nations, have such detailedpopulation-based registers which are needed to
conduct such a study.

In addition to alcohol, abuse of amphetamines and opiates such asheroin, and use of multiple drugs were linked to
the most violentcrimes.

"There needs to be more integration between the criminal justicesystem and mental health services because of this
close associationbetween crime and people who leave hospital with drug and alcoholproblems," said Fazel, who reported
his findings in the BritishMedical Journal.

"Using resources to treat people with these problems could be costeffective in terms of crime reduction," he added.

Fazel suggested that opportunities for treatment should be consideredif a person with a history of alcohol or drug
abuse has been convictedof committing a violent crime.

"Probation officers and mental health professionals should continue towork more closely," he added.

The Effect of Parental Alcohol and Drug Disorders on Adolescent PersonalityElkins IJ, McGue M, Malone S, Iacono WGAmerican
Journal of Psychiatry. 2004;161(4):670-676 This study sought to examine the relationship between parental substance use
and adolescent offspring personality. The authors chose to investigate personality because research suggests that it may be
a common mediating factor for alcoholism risk due to familial history. It is hypothesized that indicators of behavioral disinhibition
and negative emotionality may predict early onset of substance use and/or alcohol problems. It is important to identify possible
personality traits that predispose to substance use in order to create preventive interventions for teens at risk. The study
sample was derived from the Minnesota Twin Family Study, an ongoing longitudinal study of 626 twin pairs recruited at age
11 or 17 years. The adolescent cohort represented in this analysis consisted of 568 girls and 479 boys. Families had completed
a variety of assessments during the study. Personality was measured by the 198-item version of the Mutlidimensional Personality
Questionnaire, a self-report instrument. Substance-use disorders were assessed by clinician interview.Results showed that
for male and female teens, parental history of alcohol dependence was associated with greater negative emotionality, aggression,
stress reaction, and alienation, as well as lower well-being. Parental history of drug dependence/abuse was associated with
the teen traits of lower constraint, control, harm avoidance, and traditionalism, and with higher social potency. Reanalysis
by removal of teens already using substances did not change results, suggesting that the personality traits noted likely precede
onset of alcohol or drug use. The study authors reported their intentions to follow up at age 20 and 24 to observe whether
substance use was prospectively predicted by personality factors. Psychopathology Risk Transmission in Children of Parents
With Substance Use DisordersClark DB, Cornelius J, Wood DS, Vanyukov MAmerican Journal of Psychiatry. 2004;161(4):685-691
Children with paternal substance abuse history are at higher risk for conduct disorder, attention-deficit/hyperactivity
disorder (ADHD), major depressive disorder (MDD), and anxiety disorders. Many adult substance abusers have comorbid psychopathology
which may represent an additional risk factor for mental disorder in their offspring. The current study sought to clarify
transmission of risk to offspring of fathers with substance abuse. The sample population included 1167 children from 613 families
recruited through their biological fathers. Of the families, 294 had fathers with substance-use disorder (high risk) and 319
had fathers without substance use (low risk). Diagnostic assessments for both children and parents were determined by direct
clinician interview with structured instruments.Results showed that fathers in high-risk families tended to have comorbid
antisocial personality, major depression, and anxiety disorders. Low-risk fathers by definition had no mental disorders. High-risk
fathers also reported more childhood histories of ADHD and conduct disorders. High-risk-family mothers also tended to endorse
high rates of substance use, conduct disorder, MDD, and anxiety disorders. Offspring conduct disorder, ADHD, MDD, and anxiety
disorders were all significantly more common in the high-risk group. Furthermore, 3 combinations of comorbidity were commonly
seen in the youth: ADHD and conduct disorder; anxiety disorder and MDD; and ADHD and anxiety disorder. The authors concluded
that their study is consistent with disorder-specific risk transmission for psychopathology from parent to child. The genetic
and environmental factors involved in the transmission have yet to be determined. Such findings should have implications for
future preventive strategies.

You've seen the commercial: A man points to a skillet on a stove andsays, "This is drugs." He cracks an egg and dumps
the yolk into thehot skillet. As the egg begins to fry and sizzle, he concludes,"This is your brain on drugs. Any
questions?"

This is one of dozens of bold and edgy anti-drug television ads thatbegan airing in 1987 to curb rising drug use
among teens.

According to the Robert Wood Johnson Foundation, illicit drug abusecosts the nation about $414 billion annually and
takes close to15,000 lives each year. Some studies suggest nearly half of allteens in the U.S. have tried illicit
drugs.

With the government spending about $195 million annually to purchaseairtime for anti-drug ads and the Partnership
for a Drug-FreeAmerica (PDFA)-a non-profit coalition of advertising, media andpublic relations professionals-securing
more than $3 billion indonated media from broadcast, cable and radio networks since 1987,the anti-drug campaign is
the largest and most expensive in history.

There's a lot at stake. To validate the campaign messaging strategyand money being spent, a lot of research has been
conducted todemonstrate the ads' effectiveness. PDFA research findings show thatanti-drug ads do connect with teens.
The ads can be recalled and theknowledge they impart is recollected. And some studies even show adecrease in intention
to use illicit drugs.

Differences That Make a Difference

However, Carson B Wagner, an assistant professor in the Departmentof Advertising at The University of Texas at Austin,
contends thatinadequate research measures are being used to evaluate theeffectiveness of anti-drug ads and that more
valid tests demonstratethat many anti-drug ads are having the wrong effects on teens,possibly increasing the likelihood
for experimentation with drugs.

"One of the most important lessons I learned in graduate school wasthat the best kind of research reveals 'differences
that make adifference,'" says Wagner. "In other words, the morecounterintuitive the research finding, the more value
it has in thedevelopment of knowledge."

This approach led Wagner to uncover the curiosity-arousing effectsof anti-drug advertising.

"Years ago, I noticed that every time a news story was broadcastabout illicit drug use among teens, a small epidemic
would ensue,"says Wagner. "Logic instructs us that news programs and anti-drugads showing drugs in a negative light
should not lead people towarddrugs."

Adding to this oddity was a 1999 study from the Institute for SocialResearch finding that-despite their enormous
exposure to anti-drugads-tracking studies revealed that adolescents' perceived risk ofillicit drugs had rapidly decreased
and their drug use had sharplyincreased since 1991.

While there'd been a significant amount of research done about theways popular media can encourage drug use through
movies and music,there was very little research about the effects of anti-drugadvertising. And the research that did
was able to demonstrate thatthat drug attitudes became more negative as a result of anti-drugads. However, theory
and research on the psychology of curiositysuggested the opposite, and this nagged at Wagner.

Based on these observations, he hypothesized that teens exposed toanti-drug ads would express greater curiosity about
illicit drugscompared to teens not exposed to the ads-a highly counterintuitivepossibility. After proving his hypothesis
in an experiment for hismaster's thesis while at the Pennsylvania State University, Wagnerfound himself defending
his thesis the day after Congress allotted$195 million per year to anti-drug ads.

The surprising research findings agitated many, and eventually,Congress requested that Wagner's research be presented
during itsfirst review of anti-drug ad spending. Since then, a largegovernment-sponsored survey examining the first
five years of theanti-drug campaign uncovered similar findings.

In the meantime, Wagner has conducted further research on theeffects of anti-drug ads on teens. His latest asserts
there arebetter strategies to reduce drug use based, in part, on betterresearch methods.

"The majority of the current anti-drug advertising research isflawed because it relies on research participants self-reportingtheir
attitudes in response to watching anti-drug ads," explainsWagner. "However, an immense body of research reveals that,
due totheir conspicuous nature, self-reported attitude measures are highlysusceptible to social desirability, especially
with regard tosensitive issues such as drugs."

In other words, drugs and drug-use can be an uncomfortable topic,and in order to conform to social norms, research
participants mayintentionally-or unintentionally-misrepresent themselves whenreporting their attitudes, resulting
in exaggerated estimates ofanti-drug ads' effectiveness.

Measuring True Attitudes Toward Illicit Drugs

Unfortunately, when a teen is faced with a choice about drug use,the real-life situation may not lend itself to rational,
deliberatedecision-making. Often perhaps, such decisions are made in anenvironment, such as a party, packed with peer
pressure. Incircumstances like this, more often than not the decision can bemade impulsively, and it's often based
on contextual cues: Is anyoneelse doing it? Are they enjoying it?

"When a situation forces someone to make a spontaneous decision,they will rely on their internal, automatic processes,
or gutfeelings, about drugs," explains Wagner. "These associations storedin memory are called 'Strength of Association'
or SOAs. It is theseSOAs that take over when we make quick decisions or aren't motivatedto carefully think through
the choice at hand. And we need to betterunderstand how SOAs work in order to create more effective anti-drugads.

"Because of the social sensitivity associated with drugs, one of themost effective means to measure positive or negative
attitudes isto use response latency measurements of SOA," adds Wagner. "Ratherthan directly asking research participants
to express their attitudesabout drugs, response latency SOA measures allow researchers togauge people's attitudes
without their direct knowledge, therebyyielding a more accurate measure of the research participant'sattitudes that
better predicts behavioral decision-making undervarious conditions."

This unobtrusive means of measuring attitudes was developed bypsychologists in the 1970s, when self-report surveys
began showingthe widespread disappearance of prejudice, which was incongruentwith other measures of prejudice in society,
such as socioeconomicfactors.

Essentially, response latency measurement involves recording thetime it takes a research participant to categorize
a positive ornegative adjective after being primed with a certain concept-in thisinstance, illicit drugs. The more
quickly the subject categorizesnegative adjectives such as "bad" or "horrible," as opposed topositive adjectives such
as "good" or "wonderful," the stronger andmore negative their association with the idea of illicit drugs.

Armed with a less obvious method of capturing audience's attitudestoward this sensitive topic, Wagner set out to
compare the resultsof self-report questionnaires versus response latency measures anddetermine if different measurement
methods would yield similarresults.

One of Wagner's earliest research experiments measured attitudesabout drugs among teens who had watched a series
of anti-drug adsproduced by the PDFA. To gauge the persuasiveness of the ads, heused two different measures: self-report
questionnaires where peoplereported their attitudes toward drugs on scales anchored by positiveand negative adjectives,
and response latency measures where peoplewere instructed to categorize adjectives as quickly as possible.

The results showed that people who self-reported their attitudesafter viewing the anti-drug ads expressed strong
anti-drugsentiments, as opposed to the weaker anti-drug sentiments measuredin the response latency tests after viewing
the same anti-drug ads.These findings suggested that, compared to response latencymeasures, self-report measures exaggerated
the effectiveness ofanti-drug ads.

"The results of the self-report versus response latency measureshave implications for the on-going self-report, survey-basedresearch
conducted by the Institute for Social Research's Monitoringthe Future studies, which are often used to evaluate the Office
ofNational Drug Control Policy's Anti-Drug Media Campaign spearheadedby the PDFA," says Wagner. "Based on these findings,
the self-reportsurveys may have produced inflated claims of the ads' effects," heconcludes.

Media Don't Tell Us What To Think, They Tell Us What To Think About

Wagner's most compelling finding based on more effective researchmethods has important implications for the strategy
behindproducing and distributing anti-drug ads. Experimentationdemonstrated that the higher the motivation to watch
an anti-drugad-such as one that grabs your attention with an edgy, in-your-facemessage or runs during a prime, high-audience
timeslot-the morepositive the teens' SOA toward drugs, meaning the more likely theywould be to try drugs when faced
with a choice.

He uncovered this finding after conducting two experimental sessionswith four conditions using the same six anti-drug
ads from thePartnership for a Drug-Free America. The experiment began withresearch participants receiving a brief
introduction to the seriesof ads. For half of the participants, the introduction was designedto maximize motivation
to watch the ads; for the other half, theintroduction was geared to minimize attention. Half of theparticipants who
received each introduction were asked to rememberseven-digit phone numbers as they watched, simulating the kinds ofnon-advertising
thoughts people often have during commercial breaksand further minimizing the amount of attention some participantscould
pay to the ads. After viewing the anti-drug commercials,participants' SOA, along with several other ad-related responses,were
measured.

Among the many findings, Wagner's testing suggested that those whodidn't pay close attention to the ads-whether unmotivated,remembering
seven-digit numbers, or both-showed significantly higheranti-drug SOA, while those who paid the most attention had the
leastanti-drug SOA. In other words, the more attention researchparticipants paid to the anti-drug ads, the weaker
their anti-drugSOA afterward, or the more open they were to the idea of drugs.

The study won the Top Faculty Paper award for the CommunicationTheory and Methodology Division of the Association
for Education inJournalism and Mass Communication, the largest and oldest masscommunication academic organization.

"Keeping drugs on youths' agendas by using hard-hitting ads keepsthem thinking about drugs," says Wagner. "And those
same ads canmotivate people to pay attention, which can result in loweranti-drug SOA as compared to watching ads that
don't call attention."

These findings are a critically important paradigm shift foranti-drug advertising.

A Paradigm Shift for Anti-Drug Advertising

"The conventional anti-drug advertising strategy has been to producehighly visible, attention-grabbing ads, most
notably the campaignlinking drug use and terrorism, and to place them at times whenviewers are likely to be most attentive,
for example, the SuperBowl," adds Wagner. "Although this may be an effective politicalstrategy, it's less likely to
achieve the goal of preventing illicitdrug use."

The mindset behind conventional anti-drug advertising strategy, hesays, assumes that people make decisions rationally
anddeliberately. As a result, in order to persuade their audience,advertisers produce ads designed to grab the audience's
attentionand make a compelling case against drug use so that viewers can usethe arguments to protect themselves against
offers of drugs.

Based on his work in measuring SOAs, Wagner suggests that anti-drugadvertisers consider not trying so hard to motivate
viewers to payclose attention, as depicted in the ad that links drug use toterrorism.

"Instead, they might devise creative techniques to keep the audiencethinking unrelated thoughts as they watch the
ads so as to limitthe attention viewers pay to the specific drug-related arguments," hesays. "The more effective strategy
is to simply keep makingassociations between drugs and negativity repeatedly so thataudiences learn those associations
as opposed to thinking about allthe possibilities."

He also suggests that ad buyers consider placing anti-drug ads attimes when opportunity and motivation to watch are
low, such asduring TV shows with less consistent ratings, not those that havevery dedicated audiences, such as the
MTV wrestling matches and theTV programs "Friends" and "Alias."

Wagner says the "What's Your Anti-Drug?" campaign, featuring teenstalking about the activities they pursue instead
of drugs, is anexcellent example of an ad not inadvertently arousing curiosity bylimiting the focus on the anti-drug
argument and keeping viewersfocused on something else, in this case alternative activities, suchas skateboarding.

Not surprisingly, Wagner's research is starting to attractattention. Last year, Ogilvy & Mather, the agency involved
inassessing the effectiveness of the National Youth Anti-Drug MediaCampaign, called on him to share his findings and
discuss theimplications for the campaign.

Wagner's research highlights a need to rethink traditionalassumptions about anti-drug ads, but further experimentation
withthese less conspicuous SOA measures is necessary to support such acontention and to offer alternatives, he says.

Wagner's future research plans include developing response latencymeasures of curiosity that, similar to the SOA
measures, would beless sensitive to the influence of social norms and therefore moreaccurately assess possible counterproductive
effects of the ads.--

Top U.S. Physicians, Lawyers Tackle National Drug Policy: A Newsmaker Interview With David C. Lewis, MDLaurie Barclay,
MDApril 22, 2004 — Editor's Note: Prominent U.S. physicians and lawyers have joined together in a nonpartisan organization,
Physicians and Lawyers for National Drug Policy (PLNDP), to advocate for a public health approach to federal and state substance
abuse policies.Since its inception in 1997, the group has believed that drug and alcohol policies must be based on evidence
rather than on politics, that prevention and treatment are more cost-effective than incarceration, and that substance abuse
should be afforded equal footing with other chronic, relapsing conditions in terms of access to care and insurance coverage.
The revised and expanded group, now incorporating members from the legal profession, met on April 20 at the National Press
Club in Washington, D.C., to discuss these and other issues, including the need for widespread alcohol screening in trauma
centers and emergency rooms.To learn more about PLNDP's agenda, Medscape's Laurie Barclay interviewed David C. Lewis,
MD, a member of the board of directors of the revamped group and a founder of the original group. Dr. Lewis is a professor
of medicine in community health and a professor of alcohol and addiction studies at Brown University in Providence, Rhode
Island.Medscape: What was the impetus behind the creation of PLNDP in 1997 and its recent revision and expansion?Dr.
Lewis: The creation of PLNDP in 1997 was really an expression of historical frustration, because the leadership of medicine
for almost a century had not been directly involved in the fashioning of drug policy. There were physicians during some periods
of that time who were involved, but basically it had become a criminal justice enterprise primarily. When the leadership gathered
for the first time in 1997, they struck quite a moderate and bipartisan tone saying that they wanted to really apply evidence
in evaluating drug policy, whether it be criminal justice approaches or medical and public health approaches. But they obviously
were looking for an increase in the attention we pay to public health approaches and medical approaches, which in fact meant
an expansion of treatment in a major way, both in and out of the criminal justice system. So that was really the impetus that
led to our formation. In our first meeting on a hot July day in the summer of 1997 and in two meetings at the Aspen Institute,
which were extremely well attended both by the core physician leadership group and by other leaders in law and business, we
set the groundwork for a consensus, which we followed in the ensuing years. I think that we did help turn more public
support and private support toward treatment and lessened the discrimination toward addicts and the incarceration of nonviolent
addicts. Polls in 1997 showed the public would just as soon send somebody to jail for their alcoholism or drug addiction as
send them to treatment, and by the time we finished that had changed, and I hope that we made a contribution to that change.
The new PLNDP group really came out of a discussion that we had with business, law, medicine and other health professionals.
It became clear that we would strengthen our message and be able to analyze the issues the policy insures better if we had
a combined effort with the legal profession. So this has been in the cards for some time. It has been discussed for at least
two years as part of our group, and now we have made a more formal organization with a board of directors and a leadership
council and two leading individuals, George Lundberg on the medical side and Professor Richard Bonnie on the law side. Medscape:
Why does the PLNDP feel that medical and public health approaches will be more effective than the criminal justice system
and interdiction in reducing illegal drugs?Dr. Lewis: From the evidence, that's what we ought to be doing. If you're talking
about what to do about nonviolent addicts who need treatment, quite obviously you can show that it's both the humane and cost-effective
way to provide treatment for them. There are a number of options people have now for treatment, including diversion from the
criminal justice system through something like drug courts and through other court procedures, but we felt that medical and
public health approaches were really underutilized compared to other approaches. We did a cost analysis of the cost of keeping
somebody in prison for a year, which was upwards of $30,000, versus the cost of treatment, which ranged from something like
$6,000 to something like $12,000 a year. Medscape: What specific medical and public health approaches does the PLNDP recommend,
and what would be the cost and funding base for these programs? Dr. Lewis: We haven't chosen specific projects yet; that
will come out of a meeting with the leadership council and the new board of directors. We certainly take a clear position
about what we think addiction is. Understanding that addiction is a disease does not absolve the addicted individual of responsibility
for their behavior, but their addiction should be given strong weight in the mitigation of punishment and as a basis of diversion
from the criminal justice system. So that's really the law statement part of our group. Sending people to prison does
not in itself help them recover, and the collateral consequence is that a criminal record creates enormous barriers to effective
recovery. I think it's fair to say that is an overall perspective of our law people and our medical people. Drug policy should
reflect the public health approach to prevention and treatment of substance abuse and should avoid excessive reliance on disproportionate
punishment. The United States should embrace an evidence-based, long-term strategy for controlling what is and will continue
to be an endemic social problem, taking into account the cost and benefits of every policy instrument deployed. Part of
this exercise in forming this group was to review a report from the National Research Council (2001), Informing America's
Policy on Illegal Drugs: What We Don't Know Keeps Hurting Us, on the effectiveness of our current national drug policy —
a report that really pointed out how little of the policy is based on evidence. This report has influenced particular principles
that we're going to talk about when we launch the group. Medscape: What effects would there be from shifting funds away
from drug enforcement through the criminal justice system? Dr. Lewis: You would save money and be effective in preventing
crime. One of the encouraging things about the treatment of alcoholism and drug addiction, particularly if it's treated early,
is that it's a very effective crime preventer. Generally speaking, an investment of maybe $2,000 in one year in treatment
offsets about $19,000 the following year in criminal justice costs. One of the biggest cost offsets and benefits from treatment
is decreased crime, and that's very clear from a lot of different studies. There's actually a famous study in California talking
about how $7 are saved for California tax payers for every $1 invested in drug treatment. Most of those $7 are actually saved
from reduced crime, which happens almost immediately after the person enters treatment. You don't have to wait years and years
to see that benefit. Medscape: Does the PLNDP advocate changes in criminal law pertaining to possession, use, and trafficking
in illegal drugs? Dr. Lewis: We haven't advocated any specific changes in law; because that will depend on the leadership
council and the board of directors and a council of advisors, which we're setting up for a meeting this fall. We're still
straightening out the priorities we have in terms of what we ought to address early on, but whatever we do take up it will
be entirely consistent with the statement of principles that I just referred to. If you have this discussion with me or with
other leaders from the group in October, we could be very specific about the particular issues we're going to pursue. Medscape:
In what ways does the PLNDP hope to reduce regulation of addiction treatment programs, and what effects would this have? Dr.
Lewis: One of the consensus statements from the original group about excessive federal regulation referred mostly to methadone
maintenance, which is uniquely regulated. It's the most regulated drug in the United States. Physicians are not free to prescribe
it to addicts; there's all kinds of heavy duty regulation, and it's resulted in fairly large clinics as an option for people
receiving methadone maintenance. That needs to change. One of the changes that has happened is an introduction of another
maintenance drug, buprenorphine, which can be used in primary care and private practice settings. But that too is accompanied
by too much regulation limiting the number of addicts that each practice can treat. Medscape: If more insurers cover substance
abuse treatment on an equal footing to that of diabetes, hypertension, and other chronic diseases, what effect will that have
on overall insurance costs? Dr. Lewis: Like the initial PLNDP project, we're going to want insurance benefits for addictive
disease, and we're going to want them for a lot of good reasons. First, it's cost-effective; second, it's the right thing
to do; and third, treatment is as effective as it is for diabetes, hypertension, and asthma. An article in The Journal of
the American Medical Association shows that treatment outcomes for addiction are equal to those for other chronic diseases.
The problem with insurance is self-evident: insurance companies will simply say it costs too much to insure something.
They will also say they don't want any mandates. That's understandable; as an industry, of course they don't want any mandates.
But the interesting thing about the cost is how minimal the additional cost would be for insuring alcoholism and other addictions.
That is interesting compared to some of the cost of the other chronic diseases and even the cost of mental illness, which
has more obligatory inpatient care. So the annual increase for full parity for substance abuse treatment is estimated at about
a $5 increase in insurance premiums a year to cover this. But insurance companies are in a bind, because we don't have
a systematic healthcare system in this country, and people can shift insurance companies. Insurers are always worried about
whether they can enlarge their good-risk patients and decrease their bad-risk patients, so in our health system we penalize
people with chronic disease in terms of insurance. It's unfortunate, but we can't do anything about it. Even so, accepting
the system we have, fortunately the costs are really minimal compared to what the benefits are — just the offset in
the cost of other diseases and other conditions that could be prevented and other medical and surgical costs and hospitalizations
that could be prevented by early intervention for addiction treatment. The amount of injuries that go with alcoholism
alone are astronomical in terms of the cost, and alcoholism is in fact the leading cause of decreased productivity of all
the chronic diseases in the business world. So if you look at that it makes no economic sense for these conditions not to
be fully covered, but I think the insurance industry unfortunately has a reflex reaction — that's a mandate and we don't
want it. Even if it were a mandate, it's a mandate we should have, and it's not going to raise premiums enough to make a difference
in terms of the broadly insured public. But it will make a difference to thousands and thousands of people with these diseases.
Disclosure: One PLNDP member, George Lundberg, MD, is editor-in-chief emeritus of Medscape and editor of Medscape General
Medicine (www.medgenmed.com).Reviewed by Gary D. Vogin, MD

19-Mar-2004 Contact: Michelle Person 301-443-6245 NIH/National Institute on DrugAbusePREVENTION PROGRAM CURBS
DRUG ABUSE AMONG MIDDLE-SCHOOL YOUTHResults of a recently published study show that Project ALERT, awidely used school-based
drug abuse prevention program, successfullycurbs the use of alcohol, cigarettes, and marijuana amongmiddle-school
students.

Researchers from RAND Health conducted a randomized, controlled studyin 55 South Dakota middle schools from 1997
to 1999. More than 4,000seventh-grade students were assigned to Project ALERT classes or to acontrol group that was
exposed to drug prevention measures already inplace at their schools. The analysis assessed drug use 18 monthslater.

Results showed that Project ALERT lessons significantly reduced theproportion of new cigarette users by 19 percent
and new marijuanausers by 24 percent. When compared with the control group, marijuanainitiation rates were 38 percent
lower for ALERT students who had nottried cigarettes or marijuana at the start of the study, and 26percent lower for
higher risk students who had tried cigarettes.Scores reflecting overall alcohol abuse (binge drinking and drinkingthat
led to fights, for example) were 24 percent lower for all ALERTstudents.

Project ALERT is designed to modify student attitudes and behaviorstoward alcohol, cigarettes, and marijuana. Students
are exposed to 11lessons in seventh grade and 3 reinforcement or booster lessons ineighth grade. The lessons help
students identify and resist prodrugpressures and understand the social, emotional, and physicalconsequences of using
harmful substances.

The original Project ALERT was tested in urban, suburban, and ruralschools in Oregon and California. Thus, it has
been shown to beeffective for students in a variety of communities. The present studyshows it also can be used successfully
in regions with comparativelyhigh rates of alcohol dependence, binge drinking, and current smoking.

WHAT IT MEANS: Drug prevention programs are critical to school-basedantidrug efforts and they can effect behavior
change in nonusers andin youth who already smoke and drink.

'I CAN'T HELP MYSELF'IS ADDICTION A MATTER OF CHOICE?By John StosselApril 21

- Watching TV, you'd think the whole country is addicted to something:drugs, food, gambling - even sex or shopping.

"The United States has elevated addiction to a national icon. It's oursymbol, it's our excuse," says Stanton Peele,
author of The Diseasing ofAmerica.

There are conflicting views about addiction and popular treatments. So, wetalked with researchers, psychologists
and "addicts" and asked them: Isaddiction a choice?

Publicity about addiction suggests it is a disease so powerful that addictsno longer have free will. Lawyers have
already used this"addict-is-helpless" argument to win billions from tobacco companies.

BLAMING OTHERS FOR OUR "ADDICTIONS" IS POPULAR TODAY.

In Canada, some lawyers are suing the government, saying it is responsiblefor getting people addicted to video slot
machines.

Jean Brochu says he was unable to resist the slot machines - that he was"sick." He says the government made him sick,
and his sickness led him toembezzle $50,000. Now, he's suing the government to restore his dignity andpay his therapy
bills.

Psychologist Jeff Schaler, author of Addiction Is a Choice, argues thatpeople have more control over their behavior
than they think.

"Addiction is a behavior and all behaviors are choices," Schaler says."What's next, are we going to blame fast-food
restaurants for the foods thatthey sell based on the marketing, because the person got addicted tohamburgers and french
fries?"

Well, yes, actually. Two weeks after he said that some children suedMcDonald's, claiming the fast-food chain made
them obese. They lost thefirst round in court, but they're trying again.

UNCONTROLLABLE IMPULSES?

"Impulse control disorder" is the excuse Rosemary Heinen's lawyer used toexplain Heinen's shopping. Heinen was a
corporate manager at Starbucks whoembezzled $3.7 million, which she then used to buy 32 cars, diamonds, gold,Rolex
watches, three grand pianos, and hundreds of Barbie dolls.

In court a psychiatrist testified Heinen was unable to obey the law, andshouldn't be given the seven-year prison
sentence she was facing. The judge,however, did put Heinen behind bars, sentencing her to 48 months.

The "helplessly addicted" defense seemed to work better for the Canadiangambler. The judge gave Brochu probation
and told him to see a psychologist.His mother paid back the $50,000 he stole.

Now Brochu and his lawyer are seeking $700 million on behalf of all addictedgamblers in Quebec, claiming the government
is responsible for getting themaddicted, too.

CALLING ADDICTION A DISEASE

Many scientists say addicts have literally lost control, and that theysuffer from a disease.

The National Institute on Drug Abuse calls drug addiction a "disease thatwill waste your brain." This is our government's
official policy. Andgovernment-funded researchers, like Stephen Dewey of Brookhaven NationalLabs, tend to agree.

They say their studies of addiction in monkeys and rats show that addictionis a brain disease.

"Addiction is a disease that's characterized by a loss of control," saysDewey.

Dewey takes his message to schools, showing kids brain scans that he saysprove his point. He tells students that
addiction causes chemical changesthat hijack your brain.

GENETIC DESTINY?

Dewey and other researchers say our genes predispose some of us to addictionand loss of control.

Researchers at Harvard University believe they may have found one of thosegenes in the zebrafish.

When researcher Tristan Darland put cocaine on a pad and stuck it on oneside of a fish tank, fish liked the feeling
they got so much that they hungaround the area, even after the cocaine was removed.

Then Darland bred a family of fish that had one gene altered. These fishresisted the lure of the cocaine.

Darland says this shows that addiction is largely genetic. "These fish don'tknow anything about peer pressure. They
either respond or they don't respondto the drug," he says.

At the Medical College of Wisconsin, Dr. Robert Risinger scans the brains ofhuman addicts while they watch a video
of people getting high on crack. It'swhat they call a "craving" video. He then shows them a hard-core sex film.

The brain scans show the addicts get more excited by the craving videos. Thedrugs become more powerful than sex -
because addiction's a disease thatchanges your brain, says Dewey.

I asked Dewey if he was suggesting that drug users don't have free will.

But if they don't have free will, how come so many people successfully quit?

IS THE DISEASE MESSAGE HARMFUL?

Addiction expert Sally Satel acknowledges drug addiction and withdrawal is"certainly a very intense biological process."
But she is one of manyexperts who say the addiction-as-brain-disease theory is harmful to addicts- and wrong.

She also thinks it's unhelpful to take away the stigma associated with drugabuse. "Why would you want to take the
stigma away?" she asks. "I can'tthink of anything more worthwhile to stigmatize."

"People need to get rid of the idea that addiction is caused by anythingother than themselves," says James Frey,
author of A Million Little Pieces,a book about his experience as an addict.

Frey says he took just about every drug, from alcohol to crack. Yet Freysays he wasn't powerless. He scoffs at Dewey's
claim that addicts' brainscompel them to keep taking drugs.

Many doctors agree, saying you can still choose not to take drugs, even ifthey do cause changes in your brain.

"You can look at brains all day," Satel says. "They can be lit up likeChristmas trees. But unless a person behaves
in a certain way, we wouldn'tcall them an addict."

ENVIRONMENT AND CHOICE

In fact, some researchers cite experiments that they say prove thataddiction is a matter of choice.

In Canada, researchers gave rats held in two different environments a choicebetween morphine and water. The rats
in cages chose morphine; the rats heldin a nicer environment preferred the water.

Whether you get addicted also depends on how you're treated. At Wake ForestUniversity, male monkeys lived together
for three months, and established apecking order.

The monkeys who'd been bullied by the "boss monkeys" banged a lever to getas much cocaine as they could. But the
dominant monkeys, just by virtue ofbeing dominant, had less interest in the drug.

"It's just like the human world," says Dr. Michael Nader, who conducted theexperiment.

"Individuals that have no control in their job show a greater propensity forsubstance abuse than those that have
control," Nader says.

These comparisons suggest that addiction is a choice - not a disease thattakes away free will.

The message from the treatment industry is that drug users need professionalhelp to quit. What they seldom say is
that people are quitting bad habitsall the time without professional help.

In fact, some studies suggest most addicts who recover do so withoutprofessional help.

For example, during the Vietnam War, thousands of soldiers became addictedto heroin.

The government tracked hundreds of soldiers for three years after theyreturned home. They found 88 percent of those
addicted to narcotics inVietnam no longer were.

QUITTING IS THE RULE, NOT THE EXCEPTION

Even tobacco companies now admit nicotine is addictive, but does that meanit really denies smokers' freedom?

You seldom hear about those people who just quit ... on their own. No one'ssaying it's easy to quit. But it may surprise
you that quitting is not theexception, it's the rule. Most people who've used heroin or cocaine havequit. Since 60
percent of smokers have quit - that's 50 million Americans -it seems obvious that people do have free will.

But the drug research establishment insists most addicts are enslaved, thatthey don't have free will.

Dewey says just because 50 million people have quit smoking doesn't meanthat an addiction to smoking isn't a disease.

Yes, it does, says Schaler. Schaler also says the use of the word "disease"is important, particularly in terms of
the money "addicts" are spending toget help. "If you say it's a choice not a disease, well then insurancecompanies
may not reimburse for that. ... If you say it's a choice, then thetobacco companies may not be slammed for millions of
dollars."

TREATMENT TRAP?

Some experts say the treatment industry is taking advantage of people indesperate situations.

"We're selling nicotine patches, we're selling the Betty Ford Center. Wetell people, 'You can never get over an addiction
on your own. You have tocome to us and buy something to get over an addiction.' It's not true, andit's dangerous to
tell them that," says Peele.

Former addict Frey agrees. His parents did pay for him to go to theexpensive Hazeldon Treatment Center, but Frey
says he didn't buy into themessages the center offered in counseling and therapy.

"I stopped because I have my own 12-step program and the first 11 stepsdon't mean [expletive] and the 12th is don't
do it. And I didn't do it."

Frey and other former addicts say choosing is what it takes, making thatdecision.

"You can't tell people, 'This is all you're fault and there's nothing youcan do about it,' " says Frey. "You have
to tell them, 'This is all yourfault and you can make it all better if you want to.' " Frey says he stillgets drunk.
Now he just does it differently. "I get drunk on walking mydogs, I get drunk on, you know, kissing my wife. I get drunk
on a good book.Getting drunk is just doing something that feels good." Web Resources Thefollowing Web sites offer
more information about the researchers and studiesdiscussed in John Stossel's special on addiction, Help Me, I Can't HelpMyself.
National Institute on Drug Addiction NIDA:<http://www.drugabuse.gov/NIDAHome.html>

An This Thursday sees the downgrading of cannabis from a class B to aclass C drug in Britain, putting it on a par
with tranquillizers andsteroids.

Many people welcome the move, but it has also sparked controversy.Some caution that cannabis can trigger mental illness,
whereas othersmaintain that the drug is medically useful.

In Britain, drugs are grouped into three categories. Class A drugsinclude heroin and morphine, class B drugs include
amphetamines andbarbiturates, and those in class C, now including cannabis, arejudged to be the least damaging.

Under the reclassification, the possession, production and supply ofmarijuana are still illegal, but the penalties
are different. Adultsfound carrying the drug are now more likely to receive a warning thana prison sentence. And the
maximum prison sentence for possession hasdropped from five to two years. Legally, this brings Britain in linewith
some European countries such as the Netherlands, although inpractice these laws are likely to be more strictly enforced
inBritain.

An estimated three million people in Britain take cannabis each year,some for medicinal reasons, but most for recreational
use. Thisincludes one-quarter of those aged between 16 and 24.

Mind-altering

The long-term effects of smoking marijuana are uncertain. Some arguethat cannabis can trigger schizophrenia, but
the evidence for this iscontroversial. A recent government report1 concluded that there is noclear causal link between
cannabis and mental-health problems. ButRobin Murray of the Institute of Psychiatry in London disagrees."Cannabis
nearly always exacerbates symptoms in people that alreadyhave mental-health problems," he says.

Murray has assessed cumulative data from five recent studies lookingat cannabis use and schizophrenia. People who
use cannabis are twiceas likely to develop schizophrenia than non-users, he concludes.

That said, the overall risk is low. Most people who smoke dope don'tdevelop psychosis. But some may be more vulnerable
to the drug'smind-altering effects than others.

Marijuana use may have other adverse health effects too. Regularsmokers - of cannabis or tobacco alike - are more
likely to developlung cancer and respiratory problems such as asthma. Andcontroversial studies have shown that the
drug can lower sperm countsin men and suppress ovulation in women1.

Healing powers

But the drug may have positive effects for some. Marijuana is thoughtto dull chronic pain and may ease the symptoms
of multiple sclerosis(MS), an incurable disease of the nervous system that causes spasms,pain and tremor.

In a recent large-scale trial, 60% of MS patients who took syntheticcannabis said it helped their mobility and eased
their pain andmuscle stiffness. "It doesn't suit everyone, but it does suit some,"says Clare Hodges, MS sufferer and
founder of the Alliance forCannabis Therapeutics, a pressure group that lobbies for themedicinal use of marijuana.

The reclassification isn't expected to make much difference to thosewho already take the drug, as it has been readily
available for someyears. But it may make life easier for those who use it medicinally,as arrests for cannabis possession
are expected to become lessfrequent.

1. Advisory Council on the Misuse of Drugs report: Theclassification of cannabis under the Misuse of Drugs Act 1971
(1971).|Article|

Rise in Killings Spurs New Steps to Fight GangsJanuary 17, 2004By FOX BUTTERFIELD - - NY TimesLOS ANGELES,
Jan. 16 - At a time when other types ofhomicides have been falling for a decade, police officialsand criminologists
are alarmed by one stubbornly volatilecategory, street-gang killings, whose spiraling numbers inrecent years have
prompted aggressive new antigang tacticsin Los Angeles and Chicago, the nation's youth gangcapitals.

Gang homicides rose more than 50 percent from 1999 to 2002,the last year for which national figures are available,
butpolice officials say their strong efforts in Los Angelesand Chicago produced a sharp dent in the upward trend inthose
cities last year.

Los Angeles, using new strategies pushed by Chief WilliamJ. Bratton, saw the number of gang-related homicides fallto
262 in 2003, from 374 in 2002, a drop of 30 percent. Thetotal number of homicides fell to 506 in 2003, down from645
in 2002, a 22 percent decrease.

But Chief Bratton told a national conference on gangviolence here this week that this means more than half ofLos
Angeles's killings are still being carried out bystreet gang members, an unacceptably high proportion. Gangviolence,
he said, is "the emerging monster of crime inAmerica."

Chicago was the homicide capital of the country in 2003.There, the new police superintendent, Philip J. Cline,using
many of the same tactics as Mr. Bratton, helpedreduce the city's total homicides to 599 in 2003, down from648 the
previous year. But more than 40 percent were stillgang-related.

F.B.I. officials at the conference said they had evidencethat gang members were now migrating out from Los Angelesand
Chicago to cities and smaller communities in many partsof the nation.

To underscore the threat, said James Alan Fox, a professorof criminal justice at Northeastern University in Boston,the
latest F.B.I. annual report on national crimestatistics found that youth-gang homicides had jumped tomore than 1,100
in 2002, up from 692 in 1999, the latestfigures available.

Gang homicides "are a growing problem in many cities, andit is not a problem that we have any agreed on solutionsto,"
Mr. Bratton said at the conference, which was attendedby police chiefs and agents of the Federal Bureau ofInvestigation
from around the country. Mr. Bratton, whofirst became prominent as police commissioner in New YorkCity from 1994 to
1996 when he presided over a large dropin homicides there, told the conference participants thatgang members are "domestic
terrorists" who are now "takingmore lives in this country than all the deaths fromterrorism."

As an indication of the severity of the problem, Mr. Clinetold the conference that over the past 80 years the ChicagoCrime
Commission had recorded 1,000 homicides by members ofthe Mafia, or traditional organized-crime families. But injust
the last five years, Mr. Cline said, there have been1,300 killings by street gangs in Chicago.

"The street gangs of today are worse than organized crimeever was," he said.

Some academic experts on gangs are skeptical that thelatest police efforts will make much difference in the longrun.

"This country has made very little progress against gangsin generations," said Irving Spergel, a professor emeritusat
the University of Chicago. Mr. Spergel has beenevaluating gang-prevention work in six cities for theJustice Department.

"We still don't understand street gangs," Mr. Spergel said."They are institutionalized, but very disorganized, andtheir
violence is usually not planned, like when a kid fromone gang comes across a kid from another gang in histerritory."

Malcolm W. Klein, a professor emeritus of sociology at theUniversity of Southern California and the author of "TheAmerican
Street Gang," said Hispanic gangs had been aroundSouthern California since the 1920's and black gangs sincethe late
1940's, but, he said, "nothing much has been doneabout them for decades."

One problem in dealing with these gangs, Mr. Klein said, isthat they come in several forms, and what works with onetype
of gang is counterproductive with others. For example,he said, smaller, less permanent gangs that specialize inselling
narcotics are susceptible to traditional policetactics like undercover buys and court injunctions orderingthem away
from certain locations.

"But for the larger, traditional gangs, if you crack downon them, it only makes them feel stronger and gives themmore
status," Mr. Klein said. "That's why they joined thegang in the first place."

He said the difficulty in cracking down on the big gangs isespecially pronounced in California because the state'sprison
system is in some ways run by inmates who belong togroups like the Mexican Mafia, the Crips or the Bloods, andwhen
they come home to Los Angeles, they are even moreinvolved in their gang identity.

Another possible reason for the increase in gang violence,said Abel Valenzuela, a professor of Chicano studies andurban
planning at the University of California, LosAngeles, is the continued influx of young Hispanic andAsian immigrants
with their parents into areas like LosAngeles.

"The vast majority don't belong to gangs," he said. "Butyou have some practicing downward assimilation, withparents
that are poor and struggling to hold two or threejobs, so the kids have idle time and get involved withgangs."

When Mr. Bratton became police chief here, in October 2002,the police force was demoralized after the beating ofRodney
King, the subsequent riots and the discovery of arenegade unit that had been planting evidence. The gangunits had
been disbanded, and the city signed a consentdecree that provided for monitors to weed out wrongdoing byofficers.

In the three years before Mr. Bratton's arrival, thehomicide rate had risen 51 percent.

Mr. Bratton soon discovered that officers in some of hiselite units had stopped working nights and weekends, whenmost
crime occurs. And the consent decree required thatmany had to work in marked cars and in uniform, and thatthey were
barred from using informants, all impediments todealing with gangs.

So Mr. Bratton set a priority - gang violence - andrelentlessly pushed his command staff to get more patrolofficers
on the street and to make detectives work nightsand weekends.

He also introduced Compstat, the computerizedcrime-tracking system that he employed successfully in NewYork.
It provides information on where crimes most oftenoccur, and through it Mr. Bratton has been able to holdsenior officers
accountable for lowering crime in theirdivisions.

Mr. Bratton even issued portable e-mail devices to all histop staff, giving them real-time information on everyhomicide,
as well as the per capita homicide rate in LosAngeles for the year, comparing it with the previous year.

Mr. Bratton has also been very visible, visiting dozens ofhomicide scenes and trying to enlist community leaders
andministers in his campaign against gangs.

John Mack, the president of the Los Angeles Urban League,voiced strong support for Mr. Bratton's actions. Mr. Macksaid
said he was encouraged that Mr. Bratton's plans, usingimproved computer software to target only the worst gangmembers,
"will be surgical and not a return to the bad olddays of the L.A.P.D. profiling every African-American guyon the streets."

Mr. Bratton has also enrolled a new ally in his war ongangs: the federal government. The F.B.I. and the localUnited
States attorney's office have agreed to put moreresources into prosecuting gang members in federal court,using racketeering,
drug and gun charges.

A major benefit, Mr. Bratton said, is that they will thenbe sent to federal prisons, outside of California, awayfrom
fellow gang members.

Plagued by Drugs, Tribes Revive Ancient PenaltyJanuary 18, 2004By SARAH KERSHAW and MONICA DAVEY - - NY TimesBELLINGHAM,
Wash. - For generations the Noland family hasled a troubled life on the Lummi Indian reservation here.The Nolands
have struggled with alcohol, painkillers and,more recently, crack. Seven family members are now jailed,several for
dealing drugs, on and off tribal land.

Their experience has been repeated hundreds of times onthis sprawling, desperately poor reservation of 2,000Lummi,
where addiction and crime have become pervasive. Itis the reason that the Lummi tribe has turned as a lastresort to
a severe and bygone punishment, seeking to banishfive of the young men in jail and another recentlyreleased. It is
also the reason for evicting YevonneNoland, 48, the matriarch of the Noland clan, from hermodest blue house on the
reservation, because her son, aconvicted drug dealer, was listed on the lease.

Banishment once turned unwanted members of a tribe into acaste of the "walking dead," and some people criticize itas
excessive and inhumane, more extreme than thepunishments meted out by the world outside and a betrayalof an already
fragile culture.

But a growing number of tribes across the country,grappling with a rise in drug and alcohol abuse, gambling,poverty
and violence, have used banishment in varying formsin the last decade. Tribal leaders see this ancientresponse, which
reflects Indian respect for community, as apainful but necessary deterrent.

"We need to go back to our old ways," said DarrellHillaire, chairman of the Lummi Tribal Council, shortlybefore
an early morning meeting on the reservation recentlyabout the tribe's new campaign against drugs. "We had tosay enough
is enough."

While the Lummi use banishment to root out drug dealers,other tribes, like the Chippewa of Grand Portage, Minn.,are
using it to rid the reservation of the worsttroublemakers and to preserve what they say is a shared setof core values.

Being banished can mean losing health, housing andeducation benefits, tribal rights to fishing and hunting,burial
rights, even the cash payments made to members oftribes earning hefty casino profits.

Recently, the Lummi have begun evicting the residents ofhouseholds in which someone is charged with anydrug-related
crime. That is what happened to Ms. Noland,who said she had never been arrested yet was evicted fromher home on the
reservation because of her son's convictionfor selling painkillers outside the reservation. She is nowawaiting a ruling
from the tribal court on her appeal ofthat decision.

Although banishment was not being used when Ms. Noland'snephews and her son Robert Zamora committed their crimes,she
acknowledged that the threat might have deterred them.Still, she said, the punishment is too brutal."Spiritually,
it's going to take your insides and turn theminside out."

She worries for her nephews and son. "They don't have aneducation," she said. "What are they going to do when theyget
out there? And what is the white man going to do, withthe tribe kicking us all off our own reservation? Can'tthey
see this is a catastrophe in waiting?"

Even within the Lummi Tribal Council, there is debate abouthow far the nation should go in its war on drugs,particularly
around the eviction policy.

"Would we propose taking someone's food or water?" saidPerry Adams, vice chairman of the council. "It is a humanright,
and for us to turn housing into a form of policing,I think we've gone too far. I think we had good intentions,but
does the tribe really have the right to take awaymembership in the nation?"

Tribal leaders estimate that at least 500 Indians on thereservation are addicted to painkillers or heroin andscores
of others to alcohol. Guns and violence plague someneighborhoods. Babies are born addicted to drugs. Ms.Noland's 15-month-old
grand-niece died two years ago of anoverdose after eating an OxyContin pill that was dropped onthe ground.

The loss of that baby was the turning point - when thetribe hit rock-bottom, leaders said. It came as anexploding
number of drug- and alcohol-related deaths werefilling the Lummi cemetery, along a winding road that hugsBellingham
Bay and is lined with fliers and flowers markingthe spots where drunken drivers crashed and died.

There had long been a severe alcohol problem on thereservation, a scourge throughout Indian country. Butthings
took a terrible turn in the late 1990's, whenOxyContin made its way to the reservation at a time whenthe tribe's long
history of living well off the land andwater had virtually come to an end.

Bellingham Bay and the surrounding waters once brimmed withsalmon, holding the riches that made the Lummi, known
asPeople of the Sea, one of the most successful fishingtribes. Many of those fishermen, with the salmon populationshrinking
and the unemployment rate on the reservationskyrocketing, have turned to dealing drugs.

Tribal leaders estimate the value of the annual drug tradeon the reservation is now $2 million, easily surpassingfishing
industry profits.

Mr. Hillaire, 49, and several others on the 11-member LummiTribal Council have made the fight against drugs andalcoholism
a focus over the past few years. He emphasizedthat the battle involves not just punishment but alsoeducation, prevention
programs and treatment, includingintensely spiritual healing rituals for addicts.

Some Indians say banishment, while seemingly harsh, must bestudied through the prism of tradition: It avoids bloodshedand
reflects tribes' community values.

"It's out of desperation," said Doug George-Kanentiio, whois a journalist for News From Indian Country, a nationalnewspaper,
and a member of the six nations of Iroquois,some of which imposed banishments. "They could eitherreinforce the ancestral
discipline, or they go the Americanroute, which has proven to be a failure."

Even in places like Grand Portage, where violence and drugsare relatively rare, Chippewa leaders have turned tobanishment.
The tribal lands are policed by county lawenforcement officers, but when a crowd got out of hand lastsummer, people
on the reservation demanded more than anarrest by the sheriff, more than criminal charges from acounty prosecutor.

"We see ourselves here as kind of a big family, and so weneeded to be part of the solution," said Norman W.Deschampe,
the tribal council chairman.

Just 350 members of this Chippewa band live on the banks ofLake Superior, in trailers and duplexes along roads rarelycrossed
in the winter except by tourists headed to thecasino and truckers hauling loads south to Duluth. Life ismostly quiet.
Front doors of homes are left unlocked, carkeys are left in ignitions.

But one Saturday night in July, a group of people drove upto nearby Mount Maude and wound up talking and drinking
andfighting. Along the way, some pulled knives, vandalizedcars and made death threats. Within days, another crowdpacked
into the ordinarily empty tribal council meeting,demanding change.

No banishment provision existed in Grand Portage, but thatnight the council unanimously voted to remove a mother,
hertwo grown sons and a family friend in connection with thefight, and began writing a long resolution adding"exclusion"
to the band's rules.

If the legendary version of the Indian punishment seemedsimple and stark, this one was complicated: legalistic and12
pages long. On the list of failings that can lead tobanishment are being in a gang, selling drugs, harming theband's
cultural items, disrupting a religious ceremony,unauthorized hunting or fishing and being banished fromanother reservation.

Still, the people of Grand Portage and Bellingham seebanishment as a painful, last option. Both the Lummi andthe
Chippewa have tried or are considering other actions,including drug education and treatment, curfews for youngpeople
and seminars about gangs.

In Grand Portage, there have been no additional banishmentssince the tribe adopted the notion in October, and evenHalloween
on the reservation - usually a time foregg-tossing and joy riding - went by without its usualharmless mischief.

John Morrin, a member of the tribal council, said hestruggled over the banishments. He had always leaned, hesaid,
toward counseling and repair, not rejection. "Thiswas a hard thing to do if you care about people," said Mr.Morrin,
who ultimately voted to banish the woman and herfamily, even though he said he was related to them.

The woman, Jacquelyn Jackson, now lives wherever she can.She sometimes sleeps on a cot in an elderly friend's shabbyapartment
near downtown Duluth. Other times, she stays in apile of blankets inside a tent in a dark basement of arelative's
girlfriend's house.

Ms. Jackson, 43, acknowledged that she behaved terriblythat summer night. She was drunk and violent and wrong, shesaid
on a bitterly cold recent morning in Duluth.

But she said the punishment was too severe: losing hersubsidized duplex on the reservation, losing her friends,losing
her way of life in an isolated, quiet place. "That'smy land, too," Ms. Jackson said. "I've never been homelessin my
life. I'm never homeless. But I guess I am."

In her furious moments, she said tribal politics left herbanished while others - those with friends or familymembers
on the tribal council - did wrong but were not sentaway.

In sadder moments, she wondered aloud about what washappening back in Grand Portage. What were her friendsdoing?
What had become of the grill, microwave and fans sheleft in her house and was too afraid and embarrassed to goback
for?

"I cry every night because I want to go home," she said. "Imiss that place so bad."

Prior research shows that adolescent animals are more sensitive tochronic alcohol exposure, with more pronounced
alcohol-related memoryproblems and brain damage than adult animals. A recent study has foundthat adolescent rodents
are less sensitive to the unpleasantconsequences of an alcohol-related hangover, as measured by anxiety.Such a lack
of aversive effects could help establish a persistingcycle of drinking in adolescents, leading to a future ofalcohol-related
problems.

Many people begin to experiment with alcohol use during adolescence,yet relatively little is known about alcohol's
effects during thiscritical stage of development. A study in the January issue ofAlcoholism: Clinical & Experimental
Research uses rodents to assesshangover-related anxiety in both adolescent and adults. Findingsindicate that adolescent
rodents experience less anxiety during thehangover phase, and recover faster from this hangover effect than doadult
rodents, and even show an increase in a specific form of socialactivity called "play fighting."

"We already know that adolescent rats are more resistant to themotor-impairing, sedative, and social-impairing effects
of alcoholthan adults," said Elena I. Varlinskaya, associate research professorat Binghamton University and corresponding
author for the study. "Incontrast, adolescent animals are more sensitive to chronic alcoholexposure, showing more
pronounced alcohol-related memory problems andbrain damage than adults. Similarly, human adolescents are morevulnerable
to the chronic effects of alcohol consumption than adults.They become alcohol dependent in an average of seven months
afterbeginning regular drinking, whereas adults show their first symptomsof alcohol dependency only after three years
of regular drinking."

Anxiety, a condition of unsubstantiated feelings of apprehension, isone of the psychological signs of withdrawal
from alcohol inalcohol-dependent humans. The more commonly recognized signs ofwithdrawal are physiological in nature,
such as a rapid heartbeat,increased blood pressure, sweating, nausea, and even seizures. Anxietymay also appear in
non-dependent individuals following the ingestionof substantial amounts of alcohol; this phenomenon is generallyreferred
to as a "hangover."

"[Scientists have used] the social interaction test in rodents [as] astandard test of anxiety for many years," said
Sandra J. Kelly,professor of psychology at the University of South Carolina. Inaddition, alcohol researchers have
used both anti-anxiety andanxiety-provoking drugs in conjunction with alcohol consumption tohelp establish that increased
anxiety leads to the suppression ofsocial interactions that would normally occur when two animals areplaced together.

For this study, researchers examined changes in the socialinteractions of adolescent (110 male, 110 female) and adult
(115 male,115 female) rodents at various times during the recovery periodfollowing injection of a single high dose
(4 g/kg) of either alcoholor saline.

"As expected, adult animals pre-exposed to alcohol interacted lesswith their partners than saline-exposed adult animals,"
saidVarlinskaya. "This hangover-associated suppression of socialinteractions is reminiscent of the suppression in
social interactionsseen during withdrawal from chronic alcohol. However, adolescent ratsnot only did not exhibit a
hangover-related suppression in socialinteractions, but they actually showed an increase in an age-specificform of
social activity called 'play fighting.' Thus, opposite to whatis seen in adults, adolescents became more socially responsive
duringthe hangover phase. To our knowledge, this is the first time that sucha dramatic age-related difference has
been reported in the effects ofhangover on social activity."

Both Varlinskaya and Kelly noted that the negative aspects of ahangover can stop people from drinking alcohol, whereas
the lack ofaversive effects may foster a sense of 'invulnerability' and evenencourage adolescents to drink.

"We already know that adolescents drink in social situations, in largepart to become more relaxed and sociable,"
said Varlinskaya. "Indeed,animal studies have shown that while under the influence of alcohol,adolescents show greater
facilitation of their social interactionsthan adults. The current results suggest that following a drinkingepisode,
adolescents experience a very unusual hangover effect that ismanifested by an increase in social motivation and interactions
withpeers. This increase in social motivation and desire to interact withpeers may provoke adolescents to drink again
to gain the socialbenefits associated with drinking. An alcohol-associated enhancementof social interactions, both
during a drinking episode and during thepost-alcohol recovery period, could help establish a persisting cycleof drinking
in at-risk adolescent individuals which may lead todependency and a life-long history of alcohol-related problems."

Varlinskaya said future research will again use an animal model toinvestigate why adolescents and adults manifest
alcohol hangoversdifferently, focusing on brain pathways and systems.

Jan 12, 2004TEENAGERS' USE OF ALCOHOL, DRUGS CAN BE CARRIED INTO ADULTHOODJane E. Allen LA TimesDespite
the perception that people give up their hard-drinking,drug-taking teenage ways by middle age, it's only an illusion for
theyoungest baby boomers. Big indulgers in high school tended to staythat way.

"The foundation for later substance use is set for most people by thetime they finish high school," said Alicia Merline,
a University ofMichigan psychologist who studied men and women who graduated fromhigh school between 1977 and 1983.

She and her colleagues found that those who drank heavily in schoolwere three times more likely to drink heavily
at age 35 than those whowere high school teetotalers.

Those who had tried marijuana in school were eight times more likelyto be using marijuana at 35 than those who hadn't
tried it bygraduation.

The report was published in January's American Journal of PublicHealth. It was based on responses from 7,541 people
to the Monitoringthe Future study conducted at the University of Michigan Institute forSocial Research and funded
by the National Institute on Drug Abuse.

Weeks before the drug is downgraded from Class B to Class C comes newevidence that cannabis-induced psychosis is
the bigest problem facinginner city mental health services

THERE WAS SOMETHING horribly fast and terribly chilling about theonset of Steve Hammond's psychosis. His father Terry
remembersfeeling a shiver down his spine when, sitting in front of thetelevision, Steve turned to him with a strange
look in his eyes andsaid: "Why did you ring up the BBC?" "Of course, I told him Ihadn't," Terry recalls. "But then
Steve said: 'Yes you did. You rangthem up and told them I'm a lazy, useless bastard. And they've beenbroadcasting
it all day.'"

This was the start of three years of hell for the Hammond family;three years during which Steve, a bright, handsome
and popular22-year-old, descended into madness and despair. For Terry it was themoment when he first saw the illness
for himself. For Steve it was afrightening repeat of an episode a few days earlier when, with nopapers to roll a joint,
he ate a chunk of cannabis resin andcollapsed in a nightclub toilet. "When I woke up I heard someonesaying: 'It's
OK Steve, you can get up now, you're all right'," herecalls. "When I looked around, there was no one there.

This was the start of three years of hell for the Hammond family; three years during which Steve, a bright, handsome
and popular 22-year-old, descended into madness and despair. For Terry it was the moment when he first saw the illness for
himself. For Steve it was a frightening repeat of an episode a few days earlier when, with no papers to roll a joint, he ate
a chunk of cannabis resin and collapsed in a nightclub toilet. “When I woke up I heard someone saying: ‘It’s
OK Steve, you can get up now, you’re all right’,” he recalls. “When I looked around, there was no
one there.

“That’s when my voices started and I’ve had them ever since. I was so scared you can’t imagine.
I had voices coming from everywhere — the ceiling, the floor, in my head. It was the most frightening nightmare you
could imagine, except I was awake.” Steve is one of 210,000 people in the UK who suffer from schizophrenia, and
one of a growing number who believe cannabis caused their condition. Ten years ago psychiatrists would have disagreed with
him. But three weeks before the Government is due to reclassify cannabis from a Class B to a Class C drug, that view has changed
dramatically. Some of Britain’s most senior psychiatrists say the drug is now the “No 1 problem” facing
mental health services. Psychiatrists in inner-city areas speak of cannabis being a factor in up to 80 per cent of schizophrenia
cases, and mental health specialists are bracing themselves for an increase in the problem as reclassification is misinterepreted
as an assurance that the drug is safe. For years psychiatrists have noticed a high level of cannabis use among people
with psychosis, a generic term for schizophrenia, delusional episodes, manic depression and so on. But it had always been
regarded as a chicken and egg problem; sufferers tended to have behavioural problems as adolescents and were more likely to
use drugs to counter their often miserable lives. But all that changed two years ago when a group of researchers had the idea
of relating cannabis and psychosis to the Dunedin group, a continuing long-term study of 1,000 children — now adults
— in New Zealand. They found that those who used cannabis by the age of 15 were more than three times as likely to develop
illnesses such as schizophrenia. Since then, other control groups — including a 1987 survey of 50,000 conscripts
in the Swedish army and another study in Amsterdam — have been examined again with the drug in mind, and they have all
shown that cannabis use increases the likelihood of psychosis by up to 700 per cent. Robin Murray, a professor at the
Institute of Psychiatry and a consultant psychiatrist at the Maudsley Hospital in South London, took part in the groundbreaking
research that first solved the chicken-and-egg problem. His co-authored report, published a year ago, concluded: “Although
most young people use cannabis without harm, a vulnerable minority experience harmful outcomes. A tenth of the cannabis users
by age 15 in our sample developed schizophreniform disorder by age 26 compared with 3 per cent of the remaining cohort. Our
findings suggest that cannabis use among psychologically vulnerable adolescents should be strongly discouraged by parents,
teachers, and health practitioners. Policy makers and lawmakers should concentrate on delaying onset of cannabis use.”
In an interview with The Times, Professor Murray adds: “Unfortunately there were no experts in psychosis on the
committees (the Home Affairs select committee and the Advisory Council on the Misuse of Drugs) that advised the Government
on re-classifying cannabis. That’s not a criticism — at the time, no one thought there should have been. Since
then there have been at least four studies that show the use of cannabis can significantly increase the likelihood of the
onset of psychosis. “I would say this is now the No 1 problem facing the mental health services in inner cities.
In south London the incidence of psychosis has doubled since 1964. There is a terrible drain on resources. Not only are there
people suffering from psychosis who would not be in in-patient beds if they were not using cannabis, but use of the drug also
drastically reduces the chances of recovery. People who do improve go out on the streets, meet their old dealer, begin using
the drug again and relapse. We’re not saying that the Government shouldn’t reclassify cannabis — for most
people it causes no problems — but I am saying that if they’re going to do it they should warn people of the possible
downside.” The downside for Steve Hammond, now 25, was three months in a psychiatric ward and the loss of a promising
future. After three years of treatment, he lives with his parents at their home in Southampton. His paranoia is controlled
by drugs but he still hears voices, is unable to work and remains afraid to go out alone. “I can remember it starting
as if it were yesterday,” he says. “I wouldn’t want to wish that on anyone; it was terrifying. The voices
got worse and worse as the days and months went by. I became completely paranoid. I was convinced my mind had been taken over
by aliens; well, you would — how else could you explain the voices? “My mum and dad were great. They convinced
me to go into hospital. There was a bit inside me that said, ‘Steve you need help’. When I came out I felt better,
although my voices were still there. I tried different medications and eventually the doctors found one that suited me, that
did not give me bad side effects. My voices are still there but cognitive therapy has helped me to understand them. It made
me realise that they were really my own thoughts. The doctor explained to me about how the communication system in my brain
was not functioning correctly. He explained all about neurotransmitters. It seemed to make perfect sense to me. It was a revelation
and a fantastic relief that I had not been invaded by aliens. “I didn’t have a clue that cannabis could do
this; if I had, I may have had second thoughts, or at least not smoked so much. I thought it was perfectly harmless. If it
was public knowledge that cannabis can affect your mental health in this way, young people would be more switched on to recognise
the symptoms or they might make an informed choice not to start at all. “I have tried smoking cannabis since, but
it was terrible. As soon as I took a couple of puffs it made me feel instantly crazy. It was like putting on a switch. I don’t
touch the stuff now.” The voices and hallucinations in schizophrenia result from an excess of the brain chemical
dopamine. Drugs such as cannabis, amphetamines and cocaine increase the levels of dopamine in the brain. The Lambeth Early
Onset (Leo) service at Lambeth Hospital in south London has a first-onset psychosis ward where the damaging effects of cannabis
on dopamine levels are all too easy to see. Young men and women are brought in as early as possible to improve their chances
of recovery with anti-psychotic drugs. In a year, as many as 120 patients pass through the ward — the vast majority
admitting to regular cannabis use. “It would be wrong to say that cannabis alone causes psychosis,” says Paddy
Power, a consultant psychiatrist at the unit. “It’s a bit like saying someone had a heart attack because of a
stressful incident when they also ate too much fatty food, took too little exercise and smoked. In much the same way, using
cannabis can be a major contributory factor in the onset of psychosis. You are also at greater risk of developing psychosis
from genetic factors, early brain development problems, birth trauma and even migrating to another country. If you add cannabis,
then you have a dangerous mix. “Between 70 and 80 per cent of the people who present at our unit have a history
of cannabis use that has probably been a factor in the development of their psychosis. I wouldn’t say that should prevent
a reclassification of the drug, but it would be irresponsible of the Government not to marry that with an educational programme
— particularly for parents and young people — so users can be made aware of the risks in much the same way as
we are given health warnings over alcohol and tobacco.” The Home Office says its “Frank” anti-drugs
campaign includes advice on cannabis, but its efforts on education timed for the reclassification of the drug on January 29
could be called into question. It has commissioned the mental health charity Mentor to produce a million leaflets for distribution
a month after the reclassification — on a budget of just £50,000. Mentor’s chief executive, Eric Carlin, says
much more money is needed if the message that all drugs — including cannabis — are potentially dangerous is to
get to young people. “The area has been neglected,” he says. “We are not yet clearly making the point that
if you have a history of mental illness, or if you are pre-disposed to psychosis, you are playing Russian roulette by smoking
cannabis. Our job is to try to get that message across.” But isn’t reclassifying cannabis from B to C sending
a message in itself that the drug is safe? The Home Affairs select committee that recommended the reclassification in May
2002 thinks not, even in the light of the new evidence. David Winnick, one of the MPs on the committee, says its members stand
by their recommendation. “We would not change our view,” he says. “I believe we should be warning people
that they should not take any drugs, including cannabis. But we decided that to continue to criminalise everyone who takes
cannabis would be wrong. “As opposed as I am to people smoking nicotine, I would not be in favour of banning that.
All we can do is warn people of its dangers. There was no evidence to suggest that more people would smoke cannabis simply
because we reclassified it, and I don’t believe they will.” Terry Hammond, Steve’s father, disagrees.
“Of course it sends a message,” he says. “After Steve became psychotic I spoke to a lot of his friends about
cannabis and they all thought it was perfectly safe — and they felt that the reclassification confirmed that. Since
then I have been contacted by lots and lots of parents who believe cannabis was a major factor in their sons and daughters
slipping into psychosis. I have no doubt it caused Steve’s. “Most people who smoke cannabis will probably
suffer no harm whatsoever. But for some it will be disastrous. They could sink into Steve’s world. And I wouldn’t
wish that on anyone.” DEBATE Is cannabis safe? E-mail debate@thetimes.co.uk

Methamphetamine withdrawal associated with brain changes seen in mood disordersNIH/National Institute on Drug
AbuseResults of a new study indicate that people who have recently stoppedabusing the powerfully addictive drug methamphetamine
may have brainabnormalities similar to those seen in people with mood disorders.The findings suggest practitioners
could improve success rates formethamphetamine users receiving addiction treatment by also providingtherapy for depression
and anxiety in appropriate individuals. Thestudy is published in the January 2004 issue of the journal Archivesof
General Psychiatry.

"Methamphetamine abuse is a grave problem that can lead to serioushealth conditions including brain damage, memory
loss, psychotic-likebehavior, heart damage, hepatitis, and HIV transmission," says Dr.Nora D. Volkow, director of
the National Institute on Drug Abuse(NIDA), National Institutes of Health, which funded the study."Currently, no medication
exists to treat abuse or addiction toamphetamines or amphetamine-like compounds; however, drug counselorsand other
health professionals have successfully used behavioralinterventions to treat addiction. Treatment outcomes may improve
ifassociated mental conditions are addressed concurrently withaddiction."

Dr. Edythe London and her colleagues at the University of CaliforniaLos Angeles, the University of California Irvine,
and NIDA'sIntramural Research Program used positron emission tomography--PET, atechnology to image brain activity--to
compare glucose metabolism inthe brains of 17 methamphetamine abusers who had stopped using thedrug 4-7 days before
their participation in the study, and 18nonabusers. The methamphetamine abusers averaged a 10-year history ofdrug
abuse that included consuming an average of 4 grams ofmethamphetamine per week. They said they had used the drug at least18
of the preceding 30 days.

All participants responded to questions about their drug use, andunderwent a PET scan to measure how their brains
used glucose whilethey performed an attention task. On the day of the scan,participants rated their symptoms of depression
and anxiety. Themethamphetamine abusers also rated their cravings for the drug within48 hours of the scan. The scientists
found that methamphetamineabusers reported higher ratings of depression and anxiety thannonabusers.

The PET scans showed that the two groups exhibited significantdifferences in glucose metabolism in specific brain
regions. Inmethamphetamine abusers, glucose metabolism was lower in brainregions linked to depressive disorders, depressed
mood, and sadness.It was higher in brain regions linked to anxiety and drug cravings.

"Improving our awareness of substance abuse as a condition that doesnot exist in isolation will contribute to more
effective preventionand treatment interventions," says Dr. Volkow.

Heavy, Long-Term Use of Cannabis Might Be Linked to Numerous NegativeFeatures in American UsersA DGReview
of :"Attributes of long-term heavy cannabis users: acase-control study" Psychological Medicine01/02/2004 By Jill TaylorLong-term
heavy cannabis use is associated with several negativefeatures on both objective measures and self-ratings of health andlife
satisfaction, according to researchers from McLean Hospital,Belmont, Massachusetts, United States.

To provide more current data, Amanda J. Gruber, MD, and colleaguescompared the attributes of 180 individuals, age
30 to 55 years, whowere grouped on the basis of their history of cannabis use.

Based on telephone screening, the researchers identified 63 currentlong-term heavy users (who reporting lifetime
cannabis use of 5000 ormore times and current use of 7 or more times per week), 45 formerlong-term heavy users (reporting
lifetime cannabis use of 5000 ormore times and current use of up to 1 time per week), and 72 controls(reporting lifetime
cannabis use between 1 and 50 times).

Results showed that in virtually all cases there was no statisticallysignificant difference between current and former
long-term heavyusers. Likewise, no significant differences were observed betweenheavy users (former and current user
groups combined) and controlsregarding reported levels of income and education in their familiesof origin.

Additionally, the majority of heavy users (66-90%) reported a"negative effect" in rating the subjective effects of
cannabis oncognition, memory, career, social life, physical and mental healthand quality of life.

The researchers note that whether the findings would generalise toother cultures - where patterns of cannabis use
and associatedbehaviours may be very different - is not clear.

"Further studies are needed to better understand the direction ofcausality in these associations, since this information
will beimportant for developing better strategies to treat cannabisdependence," they conclude.

Prison Rates Among Blacks Reach a Peak, Report FindsApril 7, 2003By FOX BUTTERFIELD - - NY TimesAn estimated
12 percent of African-American men ages 20 to34 are in jail or prison, according to a report releasedyesterday by
the Justice Department.

The proportion of young black men who are incarcerated hasbeen rising in recent years, and this is the highest rateever
measured, said Allen J. Beck, the chief prisondemographer for the Bureau of Justice Statistics, thestatistical arm
of the Justice Department.

By comparison, 1.6 percent of white men in the same agegroup are incarcerated.

The report found that the number of people in United Statesjails and prisons exceeded 2 million for the first timelast
year, rising to 2,019,234.

That represented an increase of 0.3 percent in the numberof people behind bars, in keeping with a slowdown in theprison
boom since the late 1990's, Mr. Beck said. But thenumber of inmates is still four times what it was beforethe enormous
increase in the prison population began in themid-1970's.

The small growth in the overall prison population last yearincluded larger changes in some states, the report found.

California, which has the largest state prison system, with160,315 inmates, had a 2.2 percent decrease in its numberof
prisoners in 2002.

Texas, which has the second-largest state prison system,with 158,131 inmates, had a drop of 3.9 percent, the reportsaid.

New York, with the fourth-largest state prison system, hada decline of 2.9 percent.

In California, much of the decline stemmed from a ballotreferendum two years ago that mandated treatment ratherthan
prison time for nonviolent drug crimes.

The drop in Texas was the result of efforts by state prisonofficials to save money by finding alternatives toimprisoning
parole violators, Mr. Beck said.

In New York the decline was the result of the drop incrime, he said.

The report found that last year, for the first time, thesize of the federal prison system surpassed that of anystate's,
with 161,681 inmates.

Some of this growth in the federal prison system wasaccounted for by the Federal Bureau of Prisons' takeover ofprisons
operated by the government of the District ofColumbia. But it also is part of the expansion of thefederal prison system
in recent years as Congress hasincreased the number of federal offenses, including manydrug crimes and gun possession
cases.

The report found that the overall prison population wasrelatively stable last year, but there was a 5.4 percentincrease
in the number of people confined in local andcounty jails, with the number rising to 665,475. This wasthe largest
growth in the jail population in five years.

Generally, people sent to jail are awaiting trial orserving sentences of a year or less.

Mr. Beck said the growth in the number of jail inmatescould be a result of the increase in crime last year,especially
property crimes like burglary, with moresuspects now awaiting trial.

Alfred Blumstein, a criminologist at Carnegie MellonUniversity, said the report highlighted variations in theway
states use prisons in their approach to reducing crime.

Louisiana, for instance, had an incarceration rate of 799inmates per 100,000 of its population, the highest rate
inthe nation. But Maine, which had the lowest rate,incarcerated 137 inmates per 100,000 of its citizens.

Some of this disparity reflects a higher crime rate inLouisiana compared with Maine, Professor Blumstein said."But
the disparity goes way beyond that into differences inpunitiveness," he said.

"People tend to think of us as one nation with oneculture," Professor Blumstein said. "I don't think thedisparities
between states are widely appreciated."

Mr. Beck said that the 12 percent of black men in their20's and early 30's in jail or prison was "a very dramaticnumber,
very significant."

That is just the rate on a given day, Mr. Beck said. Overthe course of a lifetime, the rates are much higher, hesaid.
The Bureau of Justice Statistics has calculated that28 percent of black men will be sent to jail or prison intheir
lifetime.

American Association of SuicidologyThe elderly, alcohol dependence and risk factors for suicideMood disorders,
financial difficulties, partner-relationships difficulties are contributing factors to potential for suicideSANTA
FE, NM - New research findings linking alcoholism as an established risk factor for suicide demonstrate the need for suicide
risk recognition and prevention efforts targeted to middle- and older-adults with alcohol dependence. Data also indicate
that increased age may serve as a marker for more chronic, treatment refractory alcoholism associated with greater risk
for suicide.

Presenters at two research seminars, "Risk Factors for Suicide and Medically Serious Suicide Attempts Among Alcoholics"
and "Moderators of the Relationship Between Alcohol Dependence and Suicide and Medically Serious Suicide Attempts"
will discuss new research findings in this area at the American Association of Suicidology's (AAS) 36th Annual Conference
on Saturday, April 26,2003 at 3:30 p.m. at the Inn at Loretto (Acoma North conference room) in Santa Fe, New Mexico.

"This is the first case-control postmortem study of risk factors for suicide in alcoholics using comparable research
measures and methods," notes Dr. Conner of the risk factors-related study cited above. "The most important findings
were that interpersonal factors including marital and other partner difficulties were associated with suicide risk in
this population. This extends prior uncontrolled findings."

Additionally, Dr. Conner adds that the second moderators-related study examined factors that amplify risk associated
with alcoholism. Results showed that older alcoholics are at greatest risk, a finding not previously reported in a
statistically comparable study.

These two research studies were undertaken in part because while alcoholism is an established risk factor for suicide,
data on conditions that distinguish alcoholics at particularly high risk for suicide are meager. Other research findings
to be presented by Dr. Conner and colleagues include:

* Medically serious suicide attempters with alcoholism are more likely to have a mood disorder and financial difficulties
than control subjects - i.e. community dwellers with alcoholism but without suicide attempts.* Alcoholics who complete
suicide are older, and more likely to be male, have a mood disorder, partner-relationship difficulties, and other interpersonal
life events than control subjects.* Suicide prevention efforts in alcoholics must include a focus on depression as
well as interpersonal factors including partner-relationship difficulties.

Worried Pain Doctors Decry Prosecutionswashingtonpost.com - December 29, 2003Jeri Hassman, one of Tucson's busiest
pain doctors and a specialist in rehabilitation, was getting ready to inject a patient with a pain-killing treatment one day
in March when federal officials burst into her Calmwood clinic, took off her jewelry, put her in handcuffs and led her to
jail.

Months earlier, Drug Enforcement Administration agents had placed the doctor and some of her patients under surveillance
and had sent in undercover patients complaining of pain. They knew that large doses of morphine-based drugs such as OxyContin
and Lortab were showing up around Tucson in the wrong hands, and Hassman was suspected of writing some of the prescriptions
that made that possible.

Hassman was stunned. She does not deny that she prescribed a lot of powerful drugs to many patients, but she insists
she was following good medical practice when she did.

Her clinic has elaborate machinery to stretch and reset her patients' injured muscles and bones, but she is one of many
pain doctors who have become convinced that powerful prescription narcotics are often the only way to bring real relief to
chronic pain sufferers. She saw herself as a compassionate and cutting-edge physician.

In March, the two different worldviews collided. Hassman was charged with 362 counts of prescribing controlled drugs
outside the normal practice of medicine. A single mother of two, she faces up to 28 years in prison if her trial in February
ends in convictions.

"I never, ever imagined something like this was possible," said Hassman, 47, a Cornell and New York University graduate.
"When they came into the office to arrest me, it was like a bad movie that wouldn't end."

Hassman's confusion and dismay are shared by a substantial and growing number of doctors in the troubled field of pain
management.

In recent years, similar charges of illegally prescribing prescription narcotics, criminal conspiracy, racketeering and
even murder have been brought in dozens of states against scores of doctors who treat chronic pain with prescription narcotics.
At least two have been imprisoned, one committed suicide, several are awaiting sentencing, many are preparing for trial, and
more have lost their licenses to practice medicine and accumulated huge legal bills.

Top DEA officials say only a relative handful of doctors have gotten into trouble with the law and that all were prescribing
drugs outside medical norms in a manner that amounted to trafficking. The prosecutions, they say, have had a positive effect.

"There have been a number of very high-profile cases, and they have been a learning lesson to other physicians," said
Elizabeth Willis, chief of drug operations for the DEA Office of Diversion Control. "We think doctors are much more aware
of appropriate guidelines for prescribing OxyContin now."

But increasingly worried pain specialists say that although some doctors may be running narcotic "pill mills" and even
selling prescriptions for narcotics, many others who have been arrested appear to be responsible physicians.

Their crime, it seems, is that they were supplying their chronic pain patients with sometimes large numbers of prescriptions
for controlled but legal medications to treat their pain. The result, the doctors say, is that the established medical use
of opium-based drugs for pain is becoming criminalized by aggressive drug agents and zealous prosecutors.

Adding to their concern, the official rhetoric has escalated to the point that federal and state prosecutors often accuse
arrested doctors of being no different than drug kingpins or crack dealers. After the indictment in September of McLean pain
specialist William E. Hurwitz, a prominent and controversial doctor accused of running his practice as a criminal enterprise
and prescribing OxyContin illegally, Attorney General John D. Ashcroft said the arrest showed "our commitment to bring to
justice all those who traffic in this very dangerous drug."

Some pain doctors are organizing to push back, and in recent months a loose national movement has been formed to contest
what some call the "war" being waged against pain doctors, pharmacists and suffering patients. A new group called the Pain
Relief Network is organizing a march on Washington in April to protest the prosecutions and has hired an attorney to develop
a legal strategy for appealing some of the convictions.

"Fifteen years of progress in treating patients in chronic pain could really be wiped away if these prosecutions continue,"
said Russell K. Portenoy, a pain specialist at Beth Israel Medical Center in New York who is considered one of the fathers
of modern pain management. Since the mid-1980s, Portenoy has been advocating the use of morphine-based drugs to address what
he considers to be the widespread, unnecessary and even cruel undertreatment of chronic pain.

"Treating people in pain isn't easy, and there aren't black-and-white answers," he said, agreeing that some doctors have
not been sufficiently careful about potential problems with addiction and diversion of drugs. "But what's happening now is
that the medical ambiguity is being turned into allegations of criminal behavior. We have to draw a line in the sand here,
or else the treatment will be lost, and millions of patients will suffer."

According to pain specialist Rebecca J. Patchin, a board member of the American Medical Association, an estimated 50
million Americans live with chronic pain. She says almost half of all Americans will seek care for persistent pain sometime
during their lives, but that many will not receive the treatment they need.

"Doctors hear what's happening to other physicians," she said, "and that makes them very reluctant to prescribe opioids
that patients might well need."

Fear of Addiction

Narcotics have long been used to relieve pain, and they have also long been a major concern for law enforcement. Although
natural and synthetic opioids such as morphine, codeine and oxycodone have been proved to reduce pain, they also can cause
addiction and all the problems that come with it.

Until the mid-1980s, the law enforcement concern trumped the therapeutic value, and opioids were not widely used outside
hospitals. But then research into narcotic pain relief began to show surprising results: that people in pain generally did
not become addicted to the drugs, and that many could return to near-normal life with careful narcotic treatment.

These insights led to the development of new morphine-based products such as OxyContin, a narcotic formulated to be released
over 12 hours and so better suited for pain relief. The maker of OxyContin, Purdue Pharma, actively advertised the drug to
doctors when it was introduced in 1996 and said it could not be abused because of the capsule that surrounded the active ingredients.

But Purdue Pharma was wrong about that, and by 2000 OxyContin had become a significant drug problem in many parts of
the country, especially in rural areas. Scores of deaths and thousands of emergency room visits were attributed to overdoses
from OxyContin capsules that had been broken open and the contents snorted or injected by addicts and recreational users.

Media reports of those deaths and of the spread of OxyContin abuse through sometimes improper prescribing led to a 2001
directive by the Drug Enforcement Administration to "target individuals and organizations involved in the diversion and abuse
of OxyContin."

Doctors, and sometimes their support staff, quickly became the targets of choice. The DEA also began to limit the amount
of oxycodone (the active ingredient in OxyContin) that companies were allowed to manufacture, and total production declined
by about 25 percent from 2001 to 2002.

As DEA officials see it, the medical community needs to get much better control over narcotic prescribing. The agency
has met frequently with societies representing pain doctors and pain medicine and has encouraged them to expand narcotic-use
training for physicians -- which all agree is woefully inadequate. The agency often says that it supports the legitimate use
of prescription narcotics for chronic pain sufferers and has agreed to some general guidelines worked out with those groups.

But the DEA also is the agency targeting pain doctors who write frequent narcotic prescriptions and collecting information
leading to arrests. And as many doctors have learned, the government does not require evidence of what is normally considered
criminal intent to bring charges.

"We don't have to prove extra money is being made or doctors are getting favors for prescribing," Willis of the DEA said.
"What we have to prove is that they are operating outside the course of legitimate medical practice."

That standard, however, is ever-changing, and one that is generally set by state medical boards, rather than by any single
national agency. The standard is also broad, leading to prosecutions such as the one against Hassman in Tucson. In the federal
criminal complaint against her, the sole allegation is that she prescribed controlled substances "not being in the usual course
of professional practice and not for any legitimate medical purpose." The Arizona U.S. attorney's office declined to discuss
the case.

The broadness of the medical care standard has led to drug charges against entire practices (such as the seven-doctor
Comprehensive Care and Pain Management Center in Myrtle Beach, S.C.), murder charges against a California doctor who prescribed
OxyContin for a woman who had high levels of the drug in her system when she was killed as a passenger in an auto accident,
and multiple murder charges against a Roanoke doctor for prescribing narcotics misused by patients, resulting in overdoses.
Pharmacists, doctors' office managers and receptionists have been charged as well.

In all, the DEA statistics show that the agency has opened 406 cases of OxyContin trafficking alone since 1999 and made
464 arrests. The number of investigations and prosecutions of doctors soared in the late 1990s as the problem of OxyContin
and prescription drug abuse grew, but the DEA says the number of new cases declined this year. Pain management leaders, however,
say that they have not detected any easing of law enforcement scrutiny, and they say the severity of the charges brought against
doctors has increased steadily.

The prosecutions have been aggressive -- and tenacious. When 1999 murder charges against Harvard University-trained doctor
Frank Fisher and two pharmacists were thrown out by a California judge, prosecutors filed lesser charges. They, too, were
dismissed early this year. In Roanoke, pain doctor Cecil Knox was acquitted last month of most charges against him related
to prescribing narcotics, and the other charges ended with a hung jury. The local media reported that only one juror held
out against acquitting Knox on the three most serious charges of prescribing narcotics that killed or injured patients. Federal
prosecutors said they will retry the doctor on those and other charges.

Because of the sometimes complicated legal issues involved and some doctors' fears of being targeted, few medical societies
have publicly challenged the prosecutions. The exception is the Association of American Physicians and Surgeons, a national
organization of 4,000 members dedicated to the "sanctity of the patient-physician relationship." The group is working for
congressional hearings on the pain prosecutions and will participate in the protest in Washington in the spring.

That protest is being organized by Siobhan Reynolds, founder of the Pain Relief Network and a caregiver for a chronic
pain sufferer.

"The government says that it wants to balance the needs of patients in pain with the need to keep addicts from abusing
medication, but that's not what's being accomplished," Reynolds said. "The only people being kept from using drugs in our
society are those legally entitled to use them, our sick people."

Controversial Relationship

Hassman first learned that her opioid prescribing was under review from the Arizona Medical Board, which licenses doctors.
She later found out that the board had received a complaint from an insurance company about her prescribing, she said, and
the board set up a routine and supposedly confidential meeting to discuss it.

Although the right to practice medicine is regulated by state boards, the right to prescribe controlled narcotics is
regulated by the DEA, and the parties share similar concerns, and sometimes information. In Hassman's case, that working relationship
became controversial.

According to an affidavit by Barry Cassidy, executive director of the Arizona board, Hassman was told that her conversation
was being tape-recorded. She was not told, however, that DEA agents were watching the conversation on closed-circuit television
and participating in the interview "by surreptitious means." She learned about the DEA role a year later, during discovery
proceedings for her criminal case.

Cassidy said he did not know about the DEA role and would never have approved it because board conversations are supposed
to be confidential. But Dale Austin, senior vice president of the Federation of State Medical Boards, said it is quite common
for state boards and the DEA to work together, although the degree of collaboration differs from state to state.

Hassman's attorney, Bates Butler, said the DEA-medical board connection was also at work when the Arizona board began
collecting the opioid prescribing records of two Tucson doctors who defended Hassman at a news conference. One of them, Susan
Fleming, said she believes the timing of the review was "no coincidence" and said, "I'm very concerned that one or another
of us will become the next target."

Joan Lewis, a pain specialist in Albuquerque, also ran into trouble with her state medical board after it received complaints
from insurance companies and emergency room doctors about her opioid prescribing. Although she helped write the New Mexico
medical board regulations for prescription opioid use, she was brought before the state board in 2000 and accused of "injudicious
prescribing."

She said she was worried but also angry, because she had for several years been doing elaborate research on how her patients
responded to opioids and other drugs, including one paper published in the American Journal of Pain Management.

Faced with the possible loss of her license to practice, Lewis settled with the New Mexico Board of Medical Examiners
and agreed to a pain management "mini-residency" in Tennessee, which she had to organize herself, and submitted to two years
of monitoring by a board-approved doctor. Lewis also agreed to significantly limit the strength of the opioids she prescribes,
although she said many patients improved only with much higher dosages.

The whole episode, she said, cost her at least $50,000. Although she learned some useful things about opioid use, Lewis
said, the clearest message has been that she needs to protect herself better with extensive documentation and that "it's just
not very safe for doctors to treat pain."

Published in the Dec. 15 edition of the peer-reviewed Journal ofClinical Psychiatry, the randomized, double-blind
study found thatbaclofen used in conjunction with substance abuse counselingsignificantly reduced cocaine use in recovering
addicts compared toplacebo coupled with counseling. The study was funded by the NationalInstitute on Drug Abuse as
part of a project to screen medicationswith potential for treating cocaine dependence.

"The research shows for the first time, using scientifically rigorousmethods, that Baclofen can help people reduce
their cocaine use whenthey are in drug abuse counseling," said Steven Shoptaw, the study'sprincipal investigator and
a clinical psychologist at the UCLANeuropsychiatric Institute. "Our findings give us a strong startingplace to conduct
more definite studies on whether this medication canhelp cocaine addicts when used outside controlled research clinics.This
offers new hope to hundreds of thousands of cocaine abusers whostruggle with addiction."

According to the federal Substance Abuse and Mental Health ServicesAdministration, cocaine addiction affects 1.7
million American adults.In Los Angeles County, cocaine abuse ranks second only to alcohol asthe most frequent cause
for substance abuse treatment.

Baclofen has been approved and prescribed for years to treatspasticity, particularly in muscular sclerosis patients.
Major sideeffects include fatigue and headache. Baclofen may help cocaineaddicts by inhibiting the release of the
neurotransmitter dopamine inthe brain, undercutting the "high" caused by cocaine.

The study involved 70 outpatients who underwent a 16-week cocaineaddiction treatment program. Half the participants
received baclofenand counseling and half received a placebo, or sugar pill, andcounseling. Cocaine use by the patients
was monitored using threeurine tests each week throughout the study.

The researchers found that the baclofen group, compared to the placebogroup, overall had significantly fewer urine
samples that indicatedrecent cocaine use, particularly for those participants who startedthe study with chronic, heavy
rates of crack cocaine use.

The National Institute on Drug Abuse has funded studies evaluating 60medications for cocaine addiction. Baclofen
is the third medicationthat has been recommended for a large, multicenter study. Aneight-site replication study with
larger patient populations led byShoptaw at UCLA and funded by the institute is scheduled to begin inFebruary 2004.

Shoptaw conducts his research as part of the UCLA Integrated SubstanceAbuse Programs, a unit of the UCLA Neuropsychiatric
Institute, and asa principal investigator with Friends Research Institute.

The UCLA Neuropsychiatric Institute is an interdisciplinary researchand education institute devoted to the understanding
of complex humanbehavior, including the genetic, biological, behavioral andsociocultural underpinnings of normal behavior,
and the causes andconsequences of neuropsychiatric disorders.

DRUG USE BY TEENAGERS DECLINES, CONTINUES ITS DECLINEAssociated Press - December 20, 2003WASHINGTON (AP)
- American teenagers are cutting back on their use ofillicit drugs and cigarettes, but alcohol consumption is holdingsteady,
the government says.

An annual survey of eighth-, 10th- and 12th-graders done for theDepartment of Health and Human Services, found declines
in many kindsof drugs for high school students, especially for Ecstasy and LSD.

Overall, the Bush administration said the annual survey funded by theNational Institute on Drug Abuse showed an 11
percent drop in illegaldrug use in the past two years, slightly surpassing President Bush'sgoal of a 10 percent reduction
during that period.

The survey, known as Monitoring the Future, tracked drug use andattitudes among 48,500 students from 392 schools.

There was one troubling sign: slowing declines in the use of certaindrugs by eighth graders - and a slight increase
in their use ofinhalants, said Lloyd D. Johnston, who directed the study by theUniversity of Michigan's Institute
for Social Research.

``We should take this as a little warning because eighth graders havebeen indicative of things to come in the past,''
Johnston said.

In addition, there was an overall increase in the illicit use of thesynthetic painkillers OxyContin and vicodin,
reflective of patternsseen in the general population.

The survey showed a different picture of drug use from another poll ofteens that also is used to measure the effectiveness
of White Housedrug control policy. A private study by Pride Surveys in Septembershowed illegal drug use and cigarette
smoking among sixth- through12th-graders increased slightly during the last school year comparedwith the year before.

But both surveys agreed that marijuana remains by far the most widelyused illegal drug. Monitoring the Future reported
that it had beentried at least once by 46 percent of 12th graders and used by morethan a third in the past year. Both
numbers showed a decrease overlast year.

``More kids are seeking treatment for marijuana dependency than allother drugs combined,'' John Walters, director
of the White HouseOffice of National Drug Control Policy, said at a news conference.Walters added that in 15 cities,
surveys have found that more teenssmoke marijuana than regular cigarettes.

However, he said the results were encouraging.

``This survey shows that when we push back against the drug problem,it gets smaller,'' Walters said.

Johnston and administration officials offered differing explanationsfor the decline in use of Ecstasy and LSD.

Ecstasy, also known as MDMA, is a synthetic drug considered parthallucinogen and part amphetamine. The drug became
popular at danceparties because of the energy and euphoria it gave to users, but ithas harmful side effects. It can
lead to brain, heart and kidneydamage.

Johnston said teens now are more aware about the risks of Ecstasy.

The reduced availability of LSD, following the breakup in 2000 of alab that produced large quantities of the drug,
accounted for the dropin its use, said Karen Tandy, administrator of the drug enforcementadministration. The use of
LSD is at its lowest level since thefederal government began a survey of teen-age drug use 30 years ago.

LSD, known as acid, can cause hallucinations and delusions.

The percentage of teens who smoke cigarettes has fallen dramaticallyfrom the mid-1990s, the result of advertising
campaigns and the risein cigarette prices.

But the survey showed that, among 8th- and 10th-graders, the declineslowed significantly.

William V. Corr, executive director of Campaign for Tobacco-Free Kids,said the numbers reflect a ``lack of federal
leadership on tobaccoprevention'' and decisions by cash-strapped states to cut theirprevention program.

Johnston, the study's director, said that despite progress in keepingteens from smoking, ``one-quarter of our kids,
by the end of highschool, are smoking cigarettes.''

Killings by the mentally disturbed 'increasing'By John Steele (Filed: 01/12/2003)

Killings by mentally-disturbed people living in the community in London, and immersed in "chaotic" lives of drink
and drugs, are rising yet many could be prevented, one of Britain's leading police officers said yesterday.

Tarique Ghaffur, the Metropolitan Police assistant commissioner in charge of murder squads, said suspects frequently
had a history of medical treatment but the current system for monitoring them outside hospitals needed "urgent" overhaul.

Police and other agencies dealt well with the small "top tier" of the most dangerous individuals, such as convicted
murderers released from jail or hospitals. But police, doctors, psychiatrists and others all shared some responsibility
for failing to tackle the "middle tier" - a far larger number - of disturbed, potentially violent individuals. Without
strict supervision of medication and drug and alcohol abuse, many deteriorated and the "smallest trigger" could provoke
violence.

Mr Ghaffur said: "It is not my job to criticise the shutting down of hospitals. But the issue it raises is the sheer
number of care-in-the-community institutions and hostels in amongst the communities of London.

"In the investigation into the murder of Margaret Muller, an American artist [in Victoria Park, Hackney], we have
been staggered by the sheer number of institutions in a couple of square miles."

At least 30 hostels, with hundreds of ill people, some potentially dangerous, were identified near the park. In 2002,
the Met concluded there was clear evidence of mental illness in seven murders and suspected it contributed to a number
of others.

This year, officers have established clear evidence in 10 cases, but concede that mental illness probably contributed
to other killings.

Mr Ghaffur made his comments days after Tony Hardy, the "Camden Ripper", was jailed at the Old Bailey for three murders
of women.

The Met, Mr Ghaffur said, had not been aware that Hardy, 53, had been discharged from a sectioning order under the
Mental Health Act, which kept him in hospital for much of 2001 and 2002, was living unsupervised - and slipping back into
alcohol abuse - in Camden. He killed two women after his release.

For real estate agents in Simsbury, Conn., James Dimeola seemed to bethe ultimate window shopper. He kept showing
up at open houses lastyear for homes of wildly varying prices. Sometimes he brought a womanand a child. He would tour
homes thoroughly but would never make anoffer.

Then several home sellers complained that some of their prescriptiondrugs were missing from their medicine cabinets.
An office manager fora local real estate office called police, who eventually focused onDimeola as a suspect. Dimeola,
who later acknowledged being addictedto painkillers, was convicted in January of larceny and is on twoyears' probation.

The case reflected the increasingly creative tactics that somedesperate addicts are using to worm their way into
homes so they cansteal prescription painkillers, particularly OxyContin and Percocet.Police across the nation say
that in recent months, drug thieves haveposed as potential homebuyers, garage-sale browsers, buildinginspectors and
police to get into homes -- and then into medicinecabinets.

Authorities in several cities also have reported burglaries by addictswho scanned newspaper obituaries for people
who died of cancer orother painful illnesses. While the deceased person's family membersattended the funeral, the
addicts broke into the family's home to lookfor leftover painkillers.

"Those who are seeking drugs have raised their game to a new level,"said Scott Burns of the White House Office for
National Drug ControlPolicy. "They will use any ruse to get into someone's home --'Can Iuse your bathroom? Can I use
your phone?' -- and then they clean outthe medicine cabinet and are gone before you know it."

Such incidents come at a time when the illicit use of prescriptionpainkillers is becoming more common. The 2002 National
Survey on DrugUse and Health found that 6.2 million people, 3 percent of the U.S.population, abuse prescription drugs
such as OxyContin, an addictiveopium derivative.

Reports of addicts targeting open houses have led real estate groupsto post alerts in trade magazines and on listing
services. The alertstell agents to have clients lock up medicines and other valuablesbefore open houses.

Thieves often work in pairs. One might talk with a real estate agentin one room while the other rummages through
cabinets and drawers,said Pili Meyer, a former member of a state safety panel for realestate agents. She encourages
agents to work in pairs so they do notlose sight of a client.

Sometimes, the thieves are legitimate city workers.

Two years ago in Utah, a city building inspector stole medicines whilepretending to inspect homes, Burns said. The
inspector hit about 20houses before he was caught.

"Anyone who has prescription drugs in their home is a potentialvictim," Burns said. "People are out to get your drugs
any way theycan."

MURDERERS LEARN NON-CRIMINAL THINKINGSYDNEY (Reuters) - Some of Australia's most violent criminals,including
murderers, are to be taught "non-criminal thinking" in anattempt to subdue their violent behavior.

Up to 70 hardened criminals in jails in the state of New South Wales(NSW) will participate in the nine-month program
involvingpsychologists, alcohol and drug workers, educators and prison staff,said NSW Justice Minister John Hatzistergos.

"If this program can stop violent behavior in a significant number ofinmates, then both correctional officers and
the community will besafer," Hatzistergos said in a statement received Tuesday.

"Reducing the incidence of violence in custody may also reducere-offending in the community," he said.

The NSW Serious Offenders Review Council will recommend which of thestate's most violent prisoners will take part
in the course atSydney's maximum security Long Bay jail.

To ensure the safety of psychologists teaching the criminals, cameraswill monitor lessons and staff will have duress
alarms, mobile radiosand emergency exits and Long Bay prison's riot squad will also be onstandby

Jeffron BoynesResearch EditorUniversity of Illinois at Chicago(312) 413-8702; jboynes@uic.eduResearchers at the University of Illinois at Chicago's Jane AddamsCollege of Social Work will use a $1.9 million grant
to study theimpact of drugs and the justice system on women and their children.

The grant, from the National Institute on Drug Abuse, will support afive-year pilot project of research and teaching.

"Women who have families are being locked up or losing custody oftheir children, and the social costs have yet to
be calculated," saidLarry Bennett, the study's principal investigator. "We want to lookat the effects, not only of
drugs, but of the criminal justiceresponse to drugs, and what that means for children and families ofwomen."

Statistics show that:* Nearly 80 percent of female prisoners in the United States have ahistory of drug abuse*
Two-thirds of incarcerated women in the U.S. have dependent children* One in every 129 adult women is on probation or
parole

(Source Greenfeld & Snell, 1999, "Women Offenders")

During the project, UIC faculty will work with senior substance-abuseresearchers. They envision building a substance-abuse
researchprogram centered at the Jane Addams college.

Headed by Bennett, the researchers will conduct three pilot studiesto determine what will help women successfully
leave prison, avoidreturning to prison or drugs, and take care of their children oncethey're released.

The first study will investigate the impact of social services onsubstance-abusing mothers who have lost custody
of their children.The second study will examine the social service, employment, housingand drug treatment needs of
female ex-inmates in North Lawndale -- aneighborhood with a large number of female ex-offenders. The thirdstudy will
look at the influence of HIV on caregivers of childrenwhose mothers have a history of substance abuse and are currently
inthe criminal justice system.

Called the Jane Addams Substance Abuse Research Collaboration, theproject will build on the college's tradition of
academic andcommunity collaboration, says Bennett, a social work professor. It'sa joint effort involving the college
and researchers in other UICunits, including the School of Public Health and departments ofcriminal justice, psychiatry,
urban planning and publicadministration.

UIC will also work with Loyola University's criminal justicedepartment and with a number of social service agencies,
includingTASC (Treatment Alternatives for Safe Communities).

The grant will pay for a minority research fellowship, an advisoryboard of senior research associates, and for substance-abuse
researchseminars and conferences. UIC is one of six social work programsnationwide picked to receive the grant.

In addition to its substance-abuse research, the Jane Addams Collegeof Social Work serves as home to the Great Lakes
Addiction TechnologyTransfer Center; the Midwest AIDS Training and Education Center; theMidwest Latino Health, Research,
Training, and Policy Center; theKinship Care Practice Project; and the Jane Addams Center for SocialPolicy and Research.

GROUPS WORKING TO REHABILITATE HOMELESS VETERANSVets are more likely than average to be homeless.Published
November 09. 2003 8:30AMBY KEN KUSMER ASSOCIATED PRESS WRITERINDIANAPOLIS - Darryl Boyd exudes strength from the shaved
headcrowning his 6-foot-5, 235-pound Navy veteran's body to his T-shirt'simage of bulging biceps pulling a forearm
free of shackles.

But look more closely, and you see the shirt's message: "Freedom fromActive Addiction." Listen more closely, and
Boyd speaks of a lifefilled with weakness: homelessness, alcoholism, crack addiction,mental illness, rejection by
his family.

"Every time I'd get a fleeting glimpse of reality, it was depressing,"Boyd said.

Many of the estimated 500,000 homeless among the nation's 27 millionveterans share parts of that reality. More than
two-thirds of homelessveterans battle drug and alcohol problems, according to the Departmentof Veterans Affairs, and
nearly half contend with mental illness.

This year, they are mustering to win more respect from Washington andthe public at large. A federal panel on homeless
veterans presentedits first recommendations in July, urging more mental health fundingand improved service by the
Department of Veterans Affairs.

Veterans groups also are urging more help for former militarypersonnel now out on the streets. Among their leaders
is ChuckHaenlein, a retired career Army officer and president of the board ofthe National Coalition of Homeless Veterans.

Haenlein also is president of the private, not-for-profit HoosierVeterans Assistance Foundation, which houses 127
homeless vets inhouses, apartments and a detoxification center in Indianapolis. Itsannual budget is less than $1 million,
including 30 percent fromfederal grants.

In June, the foundation created a new program allowing 40 veterans tostay in four- to eight-bedroom houses as long
as needed while theyattend a rigorous substance abuse counseling program and receivemedical care, if necessary, at
the nearby Roudebush VA Medical Center.

Drug or alcohol abuse in a homeless shelter typically means evictionback to the streets. But the new program
takes a different approach.It requires drug tests, but backsliders get sent down the street to a50-bed treatment facility.
They receive the second chances they need.

"There's a lot of baby steps, and sometimes a few steps backward,"Haenlein said.

Groups like Haenlein's are sprinkled across the country, in many casesworking with local VA hospitals to provide
a continuum of care thatincludes medical wards, detoxification centers, transitional housingand job training. The
VA in August awarded up to $8 million inper-diem payments to 44 programs in 25 states.

Veterans are not immune from the conditions that lead to homelessness,including joblessness, a shortage of affordable
housing and ashrinking public safety net. Many homeless vets no longer trust thegovernment, not even the VA, said
Ron Conley, immediate past nationalcommander of the American Legion.

"The country as a whole turned their back on them . . . so they'vekind of dropped out of society, a large part of
them," Conley said.

Surveys show that veterans overall tend to have higher incomes, bettereducations and lower poverty and unemployment
rates than the generalpopulation, but they also have a higher rate of homelessness, the VAsays. It estimates that
about a third of homeless adults are veterans,mostly men.

Congress passed the Homeless Veterans Comprehensive Assistance Act inDecember 2001. It required the VA to provide
more help for homelessvets and those at risk of becoming homeless, and to speed up theirbenefits claims. The law also
prompted the creation of a 17-member VAAdvisory Committee on Homeless Veterans.

The panel presented its first annual report in July, deliveringrecommendations in 30 areas. They include increasing
to $100 millionthe total amount the VA delivers to local agencies serving homelessvets (the statutory limit now is
$75 million) and working with theDefense Department to counsel servicemen and servicewomen at risk ofhomelessness.

Veterans groups also are taking up the issue. The largest, the 2.8million-member Legion, named a task force in January
to lift theprofile of homeless vets and create more programs to serve them. InPennsylvania, Conley heads a Legion
corporation that houses 20 vets ineight homes. Since 1987, 350 veterans have passed through their doors.

"Whoever thought we'd still be involved in it 15 years later, but herewe are," Conley said.

Vietnam vet Michael Williams, 53, drank his way out of a home and ontothe streets of Indianapolis eight years ago.
He spent a year sleepingmost nights under bridges. A fellow ex-Marine found him half-drunkoutside a mission and took
him to a Salvation Army detox center. Hecleaned himself up and began a series of jobs serving those he leftbehind
on the streets.

Williams joined Hoosier Vets last year and now treks to missions andhis old haunts, persuading homeless vets to re-enter
society.

"When you're in that kind of insanity, you can't even see the light atthe end of the tunnel," Williams said.

Boyd has been there. He enlisted in the Navy in 1982, working as aradioman on a submarine tender. After his shipmates
learned he wasgay, he tried to take his life with 60 pain pills.

The Navy discharged him in 1986, and Boyd worked as a barber. Hismother threw him out when his crack habit nearly
cost her her home. Helived on the streets of Indianapolis for more than a year, working asa prostitute and contracting
HIV. He bounced in and out of rehabprograms.

The turning point came last year. He moved into a mission andcompleted a VA drug rehabilitation program. He found
a job movingskids of textbooks for a college and took real estate classes on theside. The 12-step spirituality of
Narcotics Anonymous resonated withinhim.

Now he hopes to pass his state realty exam in January and pursue agoal of buying properties to create transitional
housing for homelessveterans.

Said Boyd, confidently pointing to his shaved head, "I've got a plangoing on here."

MANY SUBSTANCE ABUSERS 'NOT READY' TO SEEK TREATMENTPR Newswire - November 07, 2003WASHINGTON, Nov 7, 2003 /PRNewswire
via COMTEX/ -- A new report fromthe federal Substance Abuse and Mental Health Services Administration(SAMHSA) shows
that even when people recognize they are havingproblems with alcohol or drugs many do not seek treatment because theyare
"just not ready" to stop using. The report also found that manypeople do not believe they can afford to obtain treatment.

The report estimates there were about 6 million persons with illicitdrug dependence or abuse in 2002 that did not
seek specialty treatmentfor their illicit drug use. There were an estimated 17 million personsin 2002 with alcohol
dependence or abuse who did not receive specialtytreatment.

Only 6 percent of those with untreated illicit drug problems, and 4.5percent of those with untreated alcohol problems,
perceived that theyhad a need for treatment.

The report was released today by SAMHSA Administrator, Charles G.Curie at a Johnson Institute National Forum on Substance
Abuse inWashington, D.C. The data show among the 362,000 untreated persons whorecognize that they are in need of treatment
for their drug problems,39 percent indicated that they were not ready to stop using illicitdrugs and 37 percent perceived
the cost of obtaining treatment as toohigh.

For the 761,000 untreated persons who recognized in the past year thatthey needed treatment for alcohol problems,
49 percent indicated theywere not ready to stop their alcohol use and 40 percent said that thecost of treatment contributed
to their not receiving treatment.

"It is tragic that a major reason people continue to abuse illicitdrugs and alcohol is that they do not believe they
can affordappropriate treatment," Curie said. "President Bush has proposed athree year 'Access to Recovery' program
to provide $200 million moreeach year for substance abuse treatment. This program would providesomeone in need of
substance abuse treatment with a voucher to pay forthe services. We really need this program if we are to providetreatment
to the large numbers who say they cannot afford it."

The report, "Reasons for Not Receiving Substance Abuse Treatment" wasdeveloped from SAMHSA's National Survey on Drug
Use and Health. Thesurvey was based on interviews with 68,126 respondents who wereinterviewed in their homes. The
new report is available online atDrugAbuseStatistics.samhsa.gov.

SAMHSA is a public health agency within the U.S. Department of Healthand Human Services. The agency is responsible
for improving theaccountability, capacity and effectiveness of the nation's substanceabuse prevention, addictions
treatment and mental health servicedelivery systems.

University of WashingtonLessons from lives of 37 Texas murderers show different paths to death rowMurder
often begins at a terrifyingly young age. It is an awfuljourney - frequently launched by physical and sexual violence,bullying
and neglect -that terminated in 1997 with the execution of37 men convicted of murder in Texas.

This road to perdition has been chronicled in a new study exploringthe lifelong personal and environmental events
and risk factors thesemen faced. The study, published in the journal Violence and Victims,compares the lives of men
convicted of committing heinous and less-heinous murders.

The two categories were based on the severity of violence. Theheinous murders were marked by extreme rage and brutality,
use ofmultiple weapons and a seeming lack of remorse, according to leadauthor Dorothy Van Soest, dean of the School
of Social Work at theUniversity of Washington. For example, one man in this group shot,stabbed and strangled his victim.
Another stabbed his victim 50times. A third man killed someone, stuffed the body in the trunk ofhis car, talked casually
to a police officer and then went to a party.

The less-heinous murders tended to be committed during the course ofa robbery or by men who were strung out on drugs
and were stopped bythe police. Their criminal histories were largely marked by propertycrimes.

"We need to understand violence better. That does not mean condoningviolence," said Van Soest. "However, we need
to switch the focus frompunishment to prevention. We need to look at what causes violence sowe can understand the
paths leading to extreme violence." Van Soestbegan the research while she was a University of Texas at Austinsocial
work professor and associate dean. She decided to focus onTexas because that state has the highest rate of executions
in theUnited States since the death penalty was reinstated in the late1970s. Texas has accounted for more than one-third
of all executions,and in 1997 the 37 men represented half of the people put to death inthe United States.

Of the 37 men in this study, 22 were white, 13 were black and twowere Latino. Among the whites, 16 of the crimes
were evaluated asheinous and six as less heinous. There were six heinous and sevenless heinous among the blacks while
the two Latino murders were splitbetween the two categories.

A goal of the research, Van Soest said, was to examine the multipleconstellations of risk factors and see how they
may have influencedthe lives of men who were executed. To do this, she and hercolleagues reviewed all available documents
and reports on the men.These included reports and testimony given at their trials, appealdocuments and data from their
psychological, neurological, medical,social service, welfare, school, probation, and military records. Inaddition,
the researchers examined prison packets kept by the TexasDepartment of Criminal Justice, which contained their social
andcriminal histories and an FBI report on their criminal histories.Despite all of these sources, many of the records
were incomplete orsuperficial, she said, and the researchers could not determinewhether some of the risks were present
in an individual's life.

The most striking factor that springs from the study is theprevalence of childhood violence in the lives of many
of these men.Of the 20 men for whom there is evidence of childhood physical abuse,15 later were convicted of committing
heinous murders. Five of themen in the less-heinous category also were victims of childhoodphysical abuse. In addition,
virtually all those whose childhoodbackgrounds included sexual abuse, physical abuse and physical oremotional neglect
were convicted of committing the most-heinouscrimes.

The men in the heinous category were more likely to be white, poorand to have gotten involved with alcohol and drugs
at an early age.The mean starting age for alcohol was 12.6 years and it was 13.7years for other drugs. In addition,
10 of the 12 men who perpetratedsexual abuse were from the heinous group. These men also were morelikely to suffer
from hallucinations and some form of braindysfunction.

"There is some evidence that when these men were boys they tried tobe good, and later retreated to alcohol and drugs
at an early age.They were terribly abused and were just trying to survive. Some ofthe cases were heartbreaking, but
they turned out to behave as ifthey were monsters rather than hurt human beings," said Van Soest.

Men in the less-heinous group were more likely to have bullied theirpeers and had profiles that included being black,
having problems inschool, dropping out of high school and having a juvenile crimerecord.

"When people looked at these individuals they would tend to say,'These kids are trouble,'" said Van Soest. "Another
thing that thisstudy shows is that black men were executed by Texas for less-heinous crimes than those committed by
whites, which is consistentwith how the death penalty has been applied in this country."

She added that one of the damning findings of the study was a seeminginvisibility of early community intervention
when these men wereyoung.

"Society seemed to have two approaches in relation to the men in thestudy and both were damaging," Van Soest said.
" The most heinous, asboys, withdrew and self-medicated their pain. The less heinousreceived ineffective or no intervention
as children, and I suspectthat they became criminalized as they entered the justice system.

"We have hints, not answers, from this study about what went on inthe lives of these men. For example, most people
who are victims ofabuse do not commit violence, but those in the most-heinous groupwere all child victims of violence.
We need to further look at themultiple constellations of risk factors and how they work together.We also need to educate
people who work with children about whatthose factors are and counter them with protective ones."###

Co-authors of the study are Toni Johnson and Beverly McPhail, both ofwhom are expected to receive their doctorates
in social work laterthis month from the University of Texas at Austin, and Hyun-Sun Park,a University of Texas at
Austin doctoral student in social work.

HealthNewsDigest.com - November 03, 2003POTENTIAL TO HELP HIGH-RISK CHILDREN AND FAMILIES FOCUS OF STUDYBUFFALO,
N.Y. -- (HealthNewsDigest.com)...Children raised bysubstance-abusing parents often manifest substantial emotional,behavioral
and social problems. Despite this, most parents who entertreatment for substance abuse are very reluctant to allow theirchildren
to be involved in treatment or therapy.

To address the problem, researchers at the University at Buffalo'sResearch Institute on Addictions (RIA) are developing
a hybridtreatment method that incorporates training for parents, couplestherapy and reduction of substance abuse.
The project is being fundedby a $2.8 million grant from the National Institute on Drug Abuse toWilliam Fals-Stewart,
Ph.D., a senior research scientist at RIA and aresearch associate professor in the Department of Psychology, UBCollege
of Arts and Sciences.

Fals-Stewart said that 216 married or co-habiting couples, comprisedof substance-abusing fathers and nonsubstance-abusing
mothers with oneor more children, ages 0-12 years, will be recruited for the study.The men will be entering outpatient
treatment at community agenciesfor help with their drug problem.

"We've just finished a study that showed when couples participate inbehavioral couples therapy (BCT), their young
children display higherpsychosocial adjustment in the year after the parents' treatment,"Fals-Stewart said, "than
children whose parents received other formsof intervention."

The positive effects of couple's treatment -- including reducedsubstance use, improved communication and reduced
partner violence --appear to lead to improvement in the children's behavior or functioning.

According to Fals-Stewart, "Our findings suggest that BCT hassignificant effects on the family that extend beyond
the couple totheir children, even though the children were not actively involved intreatment. In the previous study,
parent skills training was not apart of the treatment and parenting issues were not even discussed.We're very hopeful
that by including this element, an even strongerstatement can be made for a new treatment method."

Secretary of Health and Human Services Tommy Thompson recently calledfor substance-abuse treatment programs to recognize
and deal with theemotional and behavioral problems of children whose parents seek helpfor alcoholism or drug abuse.
He stated, "We must not allow ourchildren to become the forgotten victims of substance abuse.

By providing appropriate services and programs, we have the power toreduce the fear and confusion that they experience
and to providetheknowledge and skills that they need to rebound and succeed as theymature into adults."

Intervention programs traditionally face barriers to involvingchildren: approximately two-thirds of fathers seeking
substance-abusetreatment and almost half of mothers seeking treatment indicate theyare unwilling to have their children
participate in individual- orfamily-based treatment. Some parents may have legal or social serviceissues, others may
not want family issues aired in front of strangers.

In other cases and depending on their age, children may refuse toparticipate, providers may not be prepared to deal
with child-relatedissues, evening hours for family appointments can be limited orunavailable and billing for these
services can be problematic foragencies with funding concerns.

Fals-Stewart's approach would allow child-related issues to beaddressed in treatment, without requiring the presence
of the child.

As a new treatment targeted at substance-abusing patients and theirchildren, this intervention has the potential
for broad and prolongedeffects that extend beyond the patients seeking treatment forsubstance abuse to the children
under their care. Such interventionsrepresent an attempt to address a chronic public-health concern. Theintervention
may prove effective with parents, their high-riskchildren as they enter adolescence and early adulthood, theirchildren's
children and society in general.

The UB investigation is just one step toward long-term clinical studyinto children's adjustment, fathers' substance
use, and family andrelationship functioning. Study of provider concerns such as extensivecost, cost-benefit and cost-effectiveness
comparisons also will beconducted.

Neil B. McGillicuddy, Ph.D., co-investigator on the research team, isa senior research scientist at RIA and an expert
in parental trainingfor families with adolescent substance abusers, interventions foradolescent drug abusers and treatment
for partners of addictedpersons.

Other co-investigators include Francis D. Fincham, Ph.D., SUNY

Distinguished Professor in the Department of Psychology, UB College ofArts and Sciences; Brian Yates of American
University in Washington,D.C., and Michelle Kelley of Old Dominion University in Norfolk, Va.

Scientists at UB's Research Institute on Addictions have beenadvancing the knowledge, prevention, and treatment of
addictions since1970.(c) Health News Digest.com 2003 All Rights Reserved.

As many as one in five of the 2.1 million Americans in jailand prison are seriously mentally ill, far outnumbering
thenumber of mentally ill who are in mental hospitals,according to a comprehensive study released Tuesday.

The study, by Human Rights Watch, concludes that jails andprisons have become the nation's default mental healthsystem,
as more state hospitals have closed and as thecountry's prison system has quadrupled over the past 30years. There
are now fewer than 80,000 people in mentalhospitals, and the number is continuing to fall.

The report also found that the level of illness among thementally ill being admitted to jail and prison has beengrowing
more severe in the past few years. And it suggeststhat the percentage of female inmates who are mentally illis considerably
higher than that of male inmates.

"I think elected officials have been all too willing to letthe incarcerated population grow by leaps and boundswithout
paying much attention to who in fact is beingincarcerated," said Jamie Fellner, an author of the reportand director
of United States programs at Human RightsWatch.

But, Ms. Fellner said, she found "enormous, unusualagreement among police, prison officials, judges,prosecutors
and human rights lawyers that something hasgone painfully awry with the criminal justice system" asjails and prisons
have turned into de facto mental healthhospitals. "This is not something that any of them wanted."

Reginald Wilkinson, director of the Ohio Department ofRehabilitation and Correction, said the "mere fact thatthis
report exists is significant."

"Some people won't like it, and the picture it paints isn'tpretty," Mr. Wilkinson said. "But getting these facts
outthere is progress."

Many of the statistics in the study have been publishedbefore by the Justice Department, the American PsychiatricAssociation
or states. But the study brings them togetherand adds accounts of the experiences of dozens of peoplewith mental illness
who have been incarcerated.

The study found that prison compounds the problems of thementally ill, who may have trouble following the everydaydiscipline
of prison life, like standing in line for ameal.

Where statistics are available, mentally ill inmates havehigher than average disciplinary rates, the study found.
Astudy in Washington found that while mentally ill inmatesconstituted 18.7 of the state's prison population, theyaccounted
for 41 percent of infractions.

This leads to a further problem - mentally ill inmates whocannot control their behavior are often, anddisproportionately,
placed in solitary confinement, thestudy found.

Solitary confinement is particularly difficult for mentallyill inmates because there is even more limited medical
carethere, and the isolation and idleness can bepsychologically destructive, the report says.

Medical care for mentally ill inmates is often almostnonexistent, the study says. In Wyoming, a JusticeDepartment
investigation found that the state penitentiaryhad a psychiatrist on duty two days a month. In Iowa, thereare three
psychiatrists for more than 8,000 inmates.

There is no single accepted national estimate of the numberof mentally ill inmates, in part because different statesuse
different ways to measure mental illness.

The American Psychiatric Association estimated in 2000 thatone in five prisoners were seriously mentally ill, with
upto 5 percent actively psychotic at any given moment.

In 1999, the statistical arm of the Justice Departmentestimated that 16 percent of state and federal prisonersand
inmates in jails were suffering from mental illness.These illnesses included schizophrenia, manic depression(or bipolar
disorder) and major depression.

One reason some experts have suggested for the highernumbers among female prisoners is that psychologists andpsychiatrists
working in prisons tend to be moresympathetic to women, finding them mentally ill, while theytend to evaluate male
inmates as antisocial or bad.

But Mr. Wilkinson said, "I think the differences are real;more female inmates are mentally ill." He suggested thatprisons
were seeing more severely mentally ill inmates now"only because the volume is greater," meaning that thenumber of
people in prison has increased.

Mon Oct 13 09:02:09 2003 Pacific TimeSPERM FROM MARIJUANA SMOKERS MOVE TOO FAST, TOO EARLY, IMPAIRINGFERTILITY,
UNIVERSITY AT BUFFALO RESEARCH SHOWSBUFFALO, N.Y., Oct. 13 (AScribe Newswire) -- Men who smokemarijuana frequently
have significantly less seminal fluid, a lowertotal sperm count and their sperm behave abnormally, all of which mayaffect
fertility adversely, a new study in reproductive physiology atthe University at Buffalo has shown.

This study is the first to assess marijuana's effects onspecific swimming behavior of sperm from marijuana smokers
and tocompare the results with sperm from men with confirmed fertility.Marijuana contains the cannabinoid drug THC
(tetrahydrocannabinol),which is its primary psychoactive chemical, as well as othercannabinoids.

Results of the study were presented today (Oct. 13, 2003) atthe annual meeting of the American Society of Reproductive
Medicine inSan Antonio.

"The bottom line is, the active ingredients in marijuana aredoing something to sperm, and the numbers are in the
direction towardinfertility," said Lani J. Burkman, Ph.D., lead author on the study.Burkman is assistant professor
of gynecology/obstetrics and urologyand head of the Section on Andrology in the UB School of Medicine andBiomedical
Sciences. UB's andrology laboratory also carries outsophisticated diagnosis for infertile couples.

"We don't know exactly what is happening to change spermfunctioning," said Burkman, "but we think it is one of two
things: THCmay be causing improper timing of sperm function by directstimulation, or it may be bypassing natural inhibition
mechanisms.Whatever the cause, the sperm are swimming too fast too early." Thisaberrant pattern has been connected
to infertility in other studies,she noted.

Burkman collaborated on earlier, published UB research that wasthe first to show that human sperm contains cannabinoid
receptors, andthat the naturally occurring cannabinoid, anandamide, which activatescannabinoid receptors in the brain
and other organs, also activatesreceptors in sperm. This evidence indicated an important role inreproduction for natural
cannabinoids.

Further research in the andrology laboratory showed that humansperm exposed to high levels of THC displayed abnormal
changes in thesperm enzyme cap, called the acrosome. When researchers testedsynthetic anandamide equivalents on human
sperm, the normal vigorousswimming patterns were changed and the sperm showed reduced ability toattach to the egg
before fertilization. Only about 10 laboratories inthe U.S. perform this array of sperm function tests.

In the current study, Burkman received seminal fluid from 22confirmed marijuana smokers and subjected the samples
to a variety oftests. The volunteers reported smoking marijuana approximately 14times a week, and for an average of
5.1 years.

Control numbers were obtained from 59 fertile men who hadproduced a pregnancy. All men abstained from sexual activity
for twodays before the lab analysis.

The samples from both groups were tested for volume,sperm-count-per-unit of seminal fluid, total sperm count, percent
ofsperm that was moving, velocity and sperm shape. Sperm also wereassessed for an important function called hyperactivation
(HA), aclosely regulated and very vigorous type of swimming that is requiredas the sperm approaches the egg. The researchers
evaluated HA andvelocity while the sperm was in seminal fluid and again after washingand incubation, when the dead
sperm were eliminated.

Results showed that both the volume of seminal fluid and thetotal number of sperm from marijuana smokers were significantly
lessthan for fertile control men. Significant differences also appearedwhen HA and velocity, both before and after
washing, were assessed,the study found.

"The sperm from marijuana smokers were moving too fast tooearly," said Burkman. "The timing was all wrong. These
sperm willexperience burnout before they reach the egg and would not be capableof fertilization."

Burkman noted that many men who smoke marijuana have fatheredchildren.

"The men who are most affected likely have naturally occurringborderline fertility potential, and THC from marijuana
may push themover the edge into infertility," she said.

As to the question of whether fertility potential returns whensmokers stop using marijuana: Burkman said the issue
hasn't beenstudied well enough to provide a definitive answer.

"THC remains stored in fat for a long period, so the processmay be quite slow. We can't say that everything will
go back tonormal. Most men who have borderline fertility are unaware of thatfact. It's difficult to know who is at
risk. I definitely would adviseanyone trying to conceive not to smoke marijuana, and that wouldinclude women as well
as men."

Additional scientists on the study included Herbert Schuel,Ph.D., UB professor of pathology and anatomical sciences,
and thestaff of the andrology laboratory.

Survey: 11 million have driven while highTuesday, September 16, 2003 Posted: 10:14 PM EDT (0214 GMT)<http://www.cnn.com/2003/US/South/09/16/drugged.driving.ap/index.html>WASINGTON (AP) -- An estimated 11 million Americans, includingnearly one in five 21-year-olds, have driven while
under theinfluence of illegal drugs, the government says.

The numbers announced Tuesday were especially high for collegestudents. Eighteen percent of students surveyed said
they drove whileon drugs last year, compared with 14 percent of their peers whoweren't in college.

John Walters, director of the White House Office of National DrugControl Policy, said the statistics show a failure
to convincedrivers that drugs impair driving as much as alcohol does. His officeis kicking off an ad campaign to warn
teens about driving whilesmoking marijuana.

"Marijuana is not the soft drug. Marijuana is not the casual rite ofpassage," Walters said at a news conference.
"We have been sendingthe wrong message."

Walters said marijuana can affect concentration, perception,coordination and reaction time for up to 24 hours after
smoking it.

"Sometimes I believed it increased my driving performance," saidStevens, who has been in drug treatment for four
months after beingcharged with possession of marijuana, cocaine and heroin. Stevensbegan smoking pot when he was 14.

The report, compiled by the U.S. Department of Health and HumanServices, used 2002 data from the National Survey
on Drug Use andHealth. The survey questioned 68,000 people. Researchers thenextrapolated the percentages to the population
as a whole. A federalstatistician said the margin of error was plus or minus 4.5percentage points.

For 21-year-olds, the rate of those who reported driving under theinfluence of drugs was 18 percent, the highest
of any age group. Thatdropped off to 14.5 percent for 22-year-olds. Unemployed adults age26 to 49 also had a high
frequency of driving while drugged -- 9.3percent, compared with 5.1 percent for drivers employed full time.

Among racial or ethnic groups, American Indians reported the highestrate of driving while drugged, at 6.3 percent
compared with 5 percentof whites, 4.5 percent of blacks, 3.7 percent of Hispanics, 3.1percent of Pacific Islanders
and 1.3 percent of Asians.

Dr. Jeffrey Runge, head of the National Highway Traffic SafetyAdministration, said there were approximately 38,000
crashes lastyear involving drivers impaired by marijuana. But Runge said hedidn't know how many fatal accidents were
caused by drugged drivers.State data collection is spotty, Runge said, and many drivers who aredriving while drugged
are also drinking.

"While we don't have fixed data, impairment is impairment," he said.

22 MILLION IN U.S. SUFFER FROM SUBSTANCE DEPENDENCE OR ABUSE, SAYS SUBSTANCEABUSE AND MENTAL HEALTH SERVICES
ADMINISTRATION9/5/03 10:20:00 AMWASHINGTON, Sept. 5 /U.S. Newswire/ -- In 2002, an estimated 22 millionAmericans
suffered from substance dependence or abuse due to drugs, alcoholor both, according to the newest results of the Household
Survey releasedtoday by the Substance Abuse and Mental Health Services Administration inthe Department of Health and
Human Services (HHS). There were 19.5 millionAmericans, 8.3 percent of the population ages 12 or older, who currentlyused
illicit drugs, 54 million who participated in binge drinking in theprevious 30 days, and 15.9 million who were heavy drinkers.

The report highlights that 7.7 million people, 3.3 percent of the totalpopulation ages 12 and older, needed treatment
for a diagnosable drugproblem and 18.6 million, 7.9 percent of the population, needed treatmentfor a serious alcohol
problem. Only 1.4 million received specializedsubstance abuse treatment for an illicit drug problem and 1.5 millionreceived
treatment for alcohol problems. Over 94 percent of people withsubstance use disorders who did not receive treatment did
not believe theyneeded treatment.

There were 362,000 people who recognized they needed treatment for drugabuse. Of them, there were 88,000 who tried
but were unable to obtaintreatment for drug abuse in 2002. There were 266,000 who tried, but couldnot obtain treatment
for alcohol abuse.

"There is no other medical condition for which we would tolerate such hugenumbers unable to obtain the treatment
they need," HHS Secretary Tommy G.Thompson said. "We need to enact President Bush's Access to Recovery Programto provide
treatment to those who seek to recover from addiction and move onto a better life. That is what Recovery Month is all
about."

The new 2002 Household Survey has been renamed the National Survey on DrugUse and Health. The survey creates a new
baseline with many improvements.The annual survey of approximately 70,000 people was released as part of thekick-off
for the 14th annual National Drug and Alcohol Addiction RecoveryMonth (Recovery Month) observance.

John Walters, White House Director of National Drug Control Policy, pointedout that "a denial gap of over 94 percent
is intolerable. People need tounderstand the addictive nature of drugs and not presume that they are 'allright' when
everyone around them knows better. Families and friends need tourge their loved ones to seek treatment when they experience
the toll thataddiction takes on loved ones and communities."

The 2002 survey found that marijuana is the most commonly-used illicit drug,used by 14.6 million Americans. About
one third, 4.8 million, used it on 20or more days in the past month. There was a decline in the number ofadolescents
under age 18 initiating use of marijuana between 2000 and 2001,according to the 2002 survey. There were 1.7 million youthful
new users in2001, down from 2.1 million in 2000. The percentage of youth ages 12-17 whohad ever used marijuana declined
slightly from 2001 to 2002, from 21.9percent to 20.6 percent. Most youngsters 12-17 reported that the lastmarijuana
they used was obtained without paying, usually from friends.

"Prevention is the key to stopping another generation from abusing drugs andalcohol," SAMHSA Administrator Charles
G. Curie said. "It is gratifying tosee that fewer adolescents under age 18 are using marijuana. Now, we need tostep
up our prevention activities to drive the numbers down further."

The survey found that 30 percent of the population 12 and older, 71.5million people, use tobacco. Most of them smoke
cigarettes. But, the numberof new daily smokers decreased from 2.1 million per year in 1998 to 1.4million in 2001.
Among youth under age 18, the decline was from 1.1 millionper year in each year between 1997 and 2000 to 757,000 in 2001.
This is adecrease from about 3,000 new youth smokers per day to 2,000 per day.

In 2002, there were 2 million persons who currently used cocaine, 567,000 ofwhom used crack. Hallucinogens were used
by 1.2 million people, including676,000 who used Ecstasy. There were 166,000 current heroin users. Amongyoungsters
12-17, inhalant use was higher than use of cocaine.

The second most popular category of drug use after marijuana is thenon-medical use of prescription drugs. An estimated
6.2 million people, 2.6percent of the population ages 12 or older, were current users ofprescription drugs taken non-medically.
Of these, an estimated 4.4 millionused narcotic pain relievers, 1.8 million used anti-anxiety medications(also known
as tranquilizers), 1.2 million used stimulants and 0.4 millionused sedatives. The survey estimates that 1.9 million persons
ages 12 orolder used OxyContin non- medically at least once in their lifetime.

Current illicit drug use is highest among young adults 18 to 25 years old,with over 20 percent using drugs. Youth
ages 12-17 also are significantusers, with 11.6 percent currently using illicit drugs. Among adults ages 26and older,
5.8 percent reported current drug use. There were also 9.5million full-time workers, 8.2 percent, who used illicit drugs
in 2002. Ofthe 16.6 million illicit drug users ages 18 or older in 2002, 12.4 millionwere employed either full or
part time.

The 2002 survey found that 11 million people, 4.7 percent of the populationages 12 or older, reported driving
under the influence of an illicit drugduring the past year. Those age 21 reported the highest rate of drivingwhile
drugged, 18 percent, but the rate was 10 percent or greater for eachage from 17 to 25.

About 10.7 million people ages 12 to 20 (28.8 percent of this age group)reported drinking alcohol in the month prior
to the survey interview. Ofthese, 7.2 million were binge drinkers (19.3 percent) and 2.3 million wereheavy drinkers
(6.2 percent). There were 33.5 million Americans who droveunder the influence of alcohol at least once in the 12 months
prior to theinterview.

Of those 3.5 million people ages 12 or older who received some kind oftreatment related to the use of alcohol or
illicit drugs in the 12 monthsprior to the survey interview, 974,000 received treatment for marijuana,796,000 received
treatment for cocaine, 360,000 received treatment for nonmedical use of narcotic pain relievers, 277,000 for heroin, and
2.2 millionreceived treatment for alcohol.

Trends in lifetime use of substances were calculated from the 2002 surveybased on reports of prior use. Use of pain
relievers non-medically amongthose ages 12-17 increased from 9.6 percent in 2001 to 11.2 percent in 2002,continuing
an increasing trend from 1989 when only 1.2 percent had ever usedpain relievers non-medically in their lifetime. Among
young adults, ages18-25, the rate of ever having used pain relievers non-medically increasedfrom 19.4 percent in 2001
to 22.1 percent in 2002. This rate was 6.8 percentin 1992.

For teens ages 12-17, the lifetime LSD rate is down from 3.3 percent of thispopulation to 2.7 percent, the Ecstasy
rate is up slightly from 3.2 percentto 3.3 percent, cocaine use is up from 2.3 percent of this population to 2.7percent,
and inhalant use is up from 9 percent in 2001 to 10.5 percent in2002.

In 2002, the survey found, over 83 percent of youth ages 12-17 reportedhaving seen or heard alcohol or drug prevention
messages outside of schoolin the past year. Youth who had seen or heard these messages indicated aslightly lower past
month use of an illicit drug (11.3 percent) than teenswho had not seen or heard these types or messages (13.2 percent).

There are 4 million adults who have both a substance use disorder andserious mental illness. In 2002, there were
an estimated 17.5 million adultsages 18 or older with serious mental illness. This is 8.3 percent of alladults. Adults
who used illicit drugs were more than twice as likely to haveserious mental illness as adults who did not use an illicit
drug. Amongadults who used an illicit drug in the past year, 17.1 percent had seriousmental illness in that year,
compared to 6.9 percent of adults who did notuse an illicit drug.

Among adults with serious mental illness in 2002, over 23 percent, weredependent on or abused alcohol or illicit
drugs. The rate among adultswithout serious mental illness was only 8.2 percent. Among adults withsubstance dependence
or abuse, 20.4 percent had serious mental illness,compared with 7 percent among adults who were not dependent on or abusingalcohol
or drugs.

The survey is based on interviews with 68,126 respondents who wereinterviewed in their homes. This includes persons
residing in dormitories orhomeless shelters. The interviews represent 98 percent of the populationages 12 and older.
Not included in the survey are persons in the activemilitary, in prisons or other institutionalized populations or who
arehomeless.

Recovery Month is a celebration of the accomplishments of people inrecovery. Since its inception, it has highlighted
the strides made insubstance abuse treatment. This year's theme, "Join the Voices for Recovery:Celebrating Health"
emphasizes that addiction to alcohol and drugs is achronic, but treatable, public health problem that affects everyone
in thecommunity. Recovery Month is celebrated to promote the message of recovery,applaud the courage of people in
recovery and recognize the contributions oftreatment providers. More than 90 organizations and individuals partner withSAMHSA
in the Recovery Month planning process.

HHS agencies -- including SAMHSA, the Centers for Disease Control andPrevention (CDC), the National Institute on
Drug Abuse (NIDA) and theNational Institute on Alcohol Abuse and Alcoholism (NIAAA) -- play a keyrole in the administration's
substance abuse strategy, leading the federalgovernment's programs in drug abuse research and funding programs andcampaigns
aimed at prevention and treatment, particularly programs designedfor youth. An HHS fact sheet with more information is
available athttp://www.hhs.gov/news/press/ . Other background and resources areavailable at the Web sites for SAMHSA ( http://www.samhsa.gov), CDC (http://www.cdc.gov), NIDA ( http://http://www.nida.nih.gov ) and NIAAA (http://www.niaaa.nih.gov ).

University of Iowa examines role of faith-based groups in helping ex-offendersEach year, nearly 500,000 people
are released from prison in theUnited States. Their success at re-entry into society often dependson the support they
receive for addressing problems such as substanceabuse, lack of job skills and a fractured personal social network.

In Iowa, where approximately 400 people are released from prison eachmonth, faith-based groups play an informal but
significant role inhelping released offenders rebuild their lives. The finding isincluded in a report by the University
of Iowa Consortium forSubstance Abuse Research and Evaluation, which set out to examine thelargely undocumented role
these local groups play in Johnson County,Iowa in helping people released from prison.

The report also finds that improved communication with formalrehabilitation services, such as probation programs
and substanceabuse groups, could help the faith-based groups be even moreeffective. In addition, these groups overall
would rather governmentdo more to support existing mandated support programs than providethem grant opportunities
for their efforts.

The study team surveyed 15 faith-based organizations (Christian,Jewish and Muslim) as well as staff with the Sixth
Judicial DistrictCorrectional Services (part of the state's Department of Corrections)and staff with the Mid-East
Council on Chemical Abuse. The resultsare available in a report called "An Environmental Scan ofFaith-Based and Community
Reentry Services in Johnson County, Iowa."The report is available online at<http://iconsortium.subst-abuse.uiowa.edu> , by sending an e-mailrequest to julia-neff@uiowa.edu or by calling 319-335-4488.

"What little work has been done on the role of faith-basedorganizations has been in very large cities. We wanted
to look attheir role in an area like Johnson County which includes a ruralpopulation," said Stephan Arndt, Ph.D.,
UI professor of psychiatryand one of the report authors.

The team was not surprised to find that the faith-based groups "domore than they think they do and more than outsiders
think they do,"said Arndt, who also is director of the UI Consortium for SubstanceAbuse Research and Evaluation.

Arndt said that people released from prison are socially disengagedand often estranged from their family, friends
and previous, if any,business associates. Add the fact that many ex-offenders arestruggling with substance abuse problems,
and it is clear a personjust out of prison could use support.

Faith-based groups help adults make a new start through study anddiscussion groups, choir, one-on-one spiritual counseling,
and sportsand social activities. They also provide practical help such asrental assistance, food and clothing banks,
and transportation.

"People tend to think that all public services have to stem fromgovernmental agencies. In truth, communities have
provided for thosein need for a long time. The lack of recognition may be becausefaith-based and community-based organizations
often do not advertisethe massive amounts of service they do," Arndt said.

The surveyors were somewhat surprised to learn that the IowaDepartment of Corrections and the substance abuse agencies
do nothave much direct communication with the faith-based agencies.

If, on being released, an offender says he wants to go to a church, acorrectional staff member's best resource currently
is to provide aphone book. A good resource to develop, Arndt said, would be adirectory that lists congregations and
describes the services andatmosphere they provide.

Another way to improve communication is for the formal supportproviders -- the correctional probation/parole officers
and substanceabuse counselors -- to attend church events such as barbeques, wherethey can learn more about how the
organizations help offenders andunderstand how referrals to faith-based groups can be made whilestill respecting separation
of church and state.

The faith-based groups themselves were open to building communicationand understanding rather than getting more money.
The consortiumfound that church and other faith-based groups are wary of acceptinggovernment funds to do their work.

"There was the general notion was that more government monies shouldgo to public social services such as help for
the disabled, children,the mentally ill and those with addictions," Arndt said.

Consortium staff also assisting with the report were Janet Hartman,program associate, and Kristina Barber, associate
director.

The Netherlands is making the drug widely available to chronically illpatients amid pressure on countries like Britain,
Canada, Australiaand the United States to relax restrictions on its supply as amedicine.

Dutch doctors will be allowed to prescribe it to treat chronic pain,nausea and loss of appetite in cancer and HIV
patients, to alleviateMS sufferers' spasm pains and reduce physical or verbal tics in peoplesuffering Tourette's syndrome.

"From September 1, 2003 pharmacies can provide medicinal cannabis topatients with a prescription from a doctor. Cannabis
has a beneficialeffect for many patients," the Health Ministry said.

The Netherlands, where prostitution and the sale of cannabis in coffeeshops are regulated by the government, has
a history of pioneeringsocial reforms. It was also the first country to legalize euthanasia.

Two companies in the Netherlands have been given licenses to growspecial strains of cannabis in laboratory-style
conditions to sell tothe Health Ministry, which in turn packages and labels the drug insmall tubs to supply to pharmacies.

As well as pharmacies, 80 hospitals and 400 doctors will be allowed todispense five-gram doses of SIMM18 medical
marijuana for 44 euros($48) a tub and more potent Bedrocan at 50 euros.

The Health Ministry recommends patients dilute the cannabis -- whichwill be in the form of dried marijuana flowers
from the hemp plantrather than its hashish resin -- in tea or turn it into a spray.

HIV SUFFERERS WELCOME MOVE

A British drug firm pioneering cannabis spray medicine to give painrelief for multiple sclerosis patients is hoping
to launch the productin Britain later this year.

The association of HIV patients in the Netherlands welcomed thegovernment's move to make cannabis available in high-streetpharmacies.

"We are glad the government recognizes that for some people it canimprove the quality of life," said Robert Witlox,
managing director ofHIV Vereniging. The association has called on health insurers to coverthe cost of the drug like
any other.

The government, which recognized many chronically ill people werealready buying cannabis from coffee shops, said
it should only beprescribed by doctors when conventional treatments had been exhaustedor if other drugs had side-effects.

The government said it would start distributing to pharmacies Monday.The Health Ministry's Office of Medicinal Cannabis
has a monopoly onwholesale distribution of the drug, grown in laboratory-styleconditions to ensure medicinal purity.

The ministry estimates up to 7,000 people in the Netherlands have usedcannabis for medical reasons, buying it in
coffee shops. It said thiscould more than double once it was available from pharmacies in puremedicinal form.

Cannabis has a long history of medicinal use. It was used as a Chineseherbal remedy around 5,000 years ago, while
Britain's Queen Victoriais said to have taken cannabis tincture for menstrual pains.

But it fell out of favor because of a lack of standardizedpreparations and the development of more potent synthetic
drugs.

Critics argue that it has not passed sufficient scientific scrutiny ata time when researchers are trying to determine
if it confers themedical benefits many users claim. Some doctors say it increases therisk of depression and schizophrenia.

Reported August 13, 2003Heroin to Treat Addiction?(Ivanhoe Newswire) -- It may sound crazy, but researchers
say giving herointo opiate addicts can help them become less dependent on the drug.

Researchers in the Netherlands conducted two separate studies of more than500 heroin addicts who did not respond
to methadone maintenance treatment.Participants were either injected with or inhaled doses of heroin, dependingon
the study in which they were enrolled.

The participants received either 12 months of methadone treatment alone, 12months of methadone treatment plus heroin,
or six months of methadonetreatment alone followed by six months of methadone plus heroin treatment.

Results show adding heroin to methadone is a safe and effective treatment.Researchers say the combination can reduce
the many physical, mental andsocial problems experienced by heroin addicts. The study shows treatmentwith heroin plus
methadone is significantly more effective than treatmentwith methadone alone.

Researchers say few serious side effects occurred during the course of thestudy. Authors conclude, "Our study provides
strong evidence of the efficacyof prescribed heroin for addicts who are resistant to other forms oftreatment."

SOURCE: British Medical Journal , 2003;327:310

THE ROOTS OF ADDICTIONStudy identifies brain area linked to drug addictionWEDNESDAY, Aug. 13 (HealthDayNews)
-- Specific nerve cells in a brainregion called the nucleus accumbens are linked to relapse inrecovering drug addicts.

That's what researchers from Rutgers University discovered. Theirreport appears in the Aug. 13 issue of the Journal
of Neuroscience .

The finding may help researchers develop new addiction therapies andintervention strategies.

Even after addicts have been drug-free for a long time, they'resusceptible to relapse when exposed to simple events
or circumstancesassociated with prior drug use. For example, walking through aparticular neighborhood or hearing a
certain song may reawakenmemories that trigger a craving and lead to a relapse.

"We've identified a part of the brain that appears to process thesememories. This might be one of the brain areas
that a very skilledpharmacological approach could target," researcher and psychologyprofessor Mark West says in a
news release.

He and his colleagues zeroed in on the nerve cells in the nucleusaccumbens during experiments with laboratory rats.
The rats were ableto self-administer cocaine by pressing a lever. Microelectrodes wereused to monitor the activity
of specific nerve cells in a part of thenucleus accumbens known as the shell.

When the rats pressed the lever to receive cocaine, a tone sounded.The rats came to associate the tone with the drug
and by the end ofthree weeks had learned to press the lever when they heard the tone.

The researchers then removed both the cocaine and lever. After amonth, the lever -- but no cocaine -- was returned
to the rats' cage.The rats ignored the lever until the tone was sounded.

"When we stared to play the tone that had been paired with cocaine,the animals began to press the lever at a fairly
high rate. Itindicated that the animals had a persistent memory -- they rememberedthe significance of the tone. We
interpreted the resumption of thelever pressing as a behavioral relapse," West says.

When the rats went through this relapse of drug seeking, themicroelectrodes monitoring brain activity showed that
the nerve cellsin the accumbens shell responded almost instantaneously when the ratsheard the tone.

Before the rats had been conditioned to associate the tone withcocaine, those nerve cells had not responded to the
tone.

Severe sentences no deterrence, say criminologistsHarsher sentences do not deter people from committing crimes,
says anew report by University of Toronto criminologists.

One of the objectives of sentencing under the Canadian Criminal Codeis to attempt to deter people from committing
crimes, says U of Tprofessor Anthony Doob, who authored the report, Sentence Severityand Crime: Accepting the Null
Hypothesis. "The implication of the lawis that harsher sentences will make us safe but our research findingssuggest
this isn't true."

Doob and post-doctoral fellow Cheryl Webster examined literature andstudies on the deterrent impact of sentences
in the U.S., Canada,England and Australia over the past 30 years. They found that themajority of studies suggest harsher
sentences do not reduce crime."It's not the penalty that causes people to pause before they commita crime; it's the
likelihood of being apprehended," says Doob.

Instead of using harsher crimes to discourage people from breakingthe law, he says more resources are needed for
social and educationalprograms for children and youth at various stages in their lives."Programs that help kids to
thrive in school are good educationalinvestments but they're also good crime prevention investments."###

Their report will appear in Crime and Justice: A Review of Research,a book to be released in August by the University
of Chicago Press.The report was funded by the Social Sciences and Humanities ResearchCouncil and Legal Aid Ontario.CONTACT:Professor
Anthony Doob, Centre for Criminology, 416-978-6438 x 230,anthony.doob@utoronto.ca

SUICIDE RISK AMONG ALCOHOLICS APPEARS TO INCREASE WITH AGEJuly 15, 2003(Alcoholism: Clinical & Experimental
Research) -- Researchers know thatalcohol disorders amplify suicide risk. At least one-third of individualswho committed
suicide also met criteria for alcohol abuse or dependence;alcohol-use disorders are a potent risk factor for suicide attempts
that areconsidered medically serious; and up to seven percent of alcoholics die bycommitting suicide. Suicide risk
among alcoholics also appears to increasewith age. A study in the July issue of Alcoholism: Clinical & ExperimentalResearch
(ACER) has found that middle-aged and older alcoholics are atgreater risk for suicide than young alcoholic adults.

"Alcoholism is a common disorder and is also a potent risk factor forsuicide," said Kenneth R. Conner, assistant
professor at the University ofRochester Medical Center and first author of the manuscript. "This was thefirst study
of a sample of adults across the age spectrum that explicitlyfocused on factors that increase the risk for suicide and
medically serioussuicide attempts associated with alcohol dependence."

For the purposes of this study, a medically serious suicide attempt wasdefined as one that required hospital admission
for up to 24 hours and metone other criterion that described the type of treatment received. "Datawere gathered from
medically serious attempters because they are a subgroupof suicide attempters who engaged in especially dangerous behavior,suggesting
a high intent to die," said Conner. Even if not successful thefirst time, he said, these individuals have an elevated
risk of dying insubsequent attempts.

"In most countries, risk for attempted suicide is highest among adolescentsand young adults," Conner continued, "whereas
the risk for completed suicideis highest among older adults. This study's findings - thatalcohol-dependent middle-aged
and older adults are at greater risk forsuicide than alcohol-dependent young adults - reinforce the notion ofdifferent
age-related patterns in attempted suicide and completed suicide."

"Little is known about how suicide risk may shift with age," said Paul R.Duberstein, associate professor of psychiatry
and director of the Laboratoryof Personality and Development at the University of Rochester MedicalCenter. "Too often
researchers in this area ignore the role of age, assumingthat risk is 'stable' across the life course, as if the risk
for suicide ina 25-year-old alcoholic is identical to that in a 65-year-old alcoholic."

For the ACER study, researchers examined data gathered by Annette L.Beautrais and colleagues for the Canterbury Suicide
Project, a case-controlstudy of suicides, medically serious suicide attempts, and randomly selectedcomparison subjects
from the Canterbury region of New Zealand. In theanalyses, all of the subjects were 18 years of age or older: 193 (149
males,44 females) had died by committing suicide; 240 (114 males, 126 females) hadmade a medically serious suicide
attempt; and 984 (476 males, 508 females)were community controls. Researchers compared demographic and diagnosticvariables.

Results indicate that the association between alcohol dependence and suicidebecomes amplified with age; however,
the association between alcoholdependence and medically serious suicide attempts does not. Increased agealso appears
to amplify the association between mood disorders and suicide,whereas decreased age appears to strengthen the association
between mooddisorders and medically serious suicide attempts.

"This study shows that suicide risk in alcoholics increases with age," saidDuberstein. "This study also shows that
if you have a mood disorder, such asdepression, the likelihood of suicide increases as you get older. I thinkthe authors
are absolutely correct in concluding that 'the increased riskfor suicide among older adults documented in western cultures
may beattributable in large part to the increased vulnerability of older adults tocomplete suicide in the context
of alcohol dependence and mood disorders.'Furthermore, the study also challenges the myth that suicide is 'morerationale'
in older adults. Of course, there are rational suicides, but theyare the exceptions. Most suicides have a diagnosable
and treatable mentalillness at the time of death."

Duberstein said there is a clear need for longitudinal research in order tobetter understand the mechanisms underlying
the heightened risk of suicideassociated with older age, [depression and alcohol dependence.] Conner saidhe plans
to "examine suicidal behavior among individuals with alcoholism,including a focus on drinking patterns that distinguish
those at especiallyhigh risk."

EUGENE, Ore. -- Sending teens with troubles to live together in group homesand residential treatment centers didn't
seem to make sense to PatriciaChamberlain. Instead of breaking old habits, the juveniles were learning newones that
made it more likely that they would be back behind bars or deadbefore they reached 21.

"We were fighting a losing battle," said Chamberlain, a senior staff memberat the Oregon Social Learning Center,
a nonprofit research group based here.

The 54-year-old clinical psychologist came up with a novel idea: Separatethe children, put them with highly trained
foster families and closelymonitor them. The divide-and-conquer strategy paid off. Researchers foundthat the teenagers
tended to stay out of trouble. They graduated from highschool. Some got full-time jobs. All at a cost far lower than that
of grouphomes and treatment centers.

Twenty years later, Chamberlain's program, called Multidimensional TreatmentFoster Care, is spreading nationwide.
Fifteen cities, including Lynchburg,Va., and Detroit, have adopted her model for juveniles, many with federalgrants.

"I like the program because it is very structured," said Richard Boothe, whomanages the program for Central Virginia
Community Services, agovernment-chartered mental health agency in Lynchburg. Twenty teenagershave been through Lynchburg's
program in two years, at a cost of $129 perchild per day.

"This is something the nation needs to know about," said Kenyatta Stephens,chief operating officer of Detroit-based
Black Family Development Inc.,which is running the new program with the Wayne County juvenile justicedepartment.

Renee Klarich, a supervisor at Black Family Development, said Detroitofficials were having a difficult time finding
mental health care for thechildren and alternatives to group homes and treatment centers. Klarich saidthe new program
costs $145 per day, compared with $340 at a treatmentcenter.

"If it's well-implemented, not only does it work, but on a cost-benefitanalysis it's one of the best things we have
in the nation," said Delbert S.Elliott, chairman of the Center for the Study and Prevention of Violence, aColorado-based
research group.

The new approach has limitations. Teenagers who have committed rape ormurder generally are not accepted, and the
program's biggest successes haveso far come in less urban areas, such as Eugene. But officials who examinedit as part
of national surveys say the Detroit experience holds promise forurban centers.

In one study of 79 boys, researchers found that juveniles who went throughthe new program had much lower rearrest
rates than those who went throughtraditional approaches -- 59 percent vs. 93 percent.

Under the new program, managers recruit foster families and pay them about$1,200 a month. The families then go through
intense child psychologytraining sessions before teenagers are placed in their homes. The youthsreceive points for
good behavior, which they can redeem for phone calls, gymvisits and trips to the movies. Teams of psychologists, therapists
andsocial workers monitor the foster families and the children daily.

The program's goal is to reunite children with their families. The teamshelp those families with parenting skills,
drug and alcohol treatment andother services. For many of the teenagers, the program is a milestone thattends to improve
self-esteem.

Shannon and Jerry Stone, a couple who live in the Oregon foothills of theCascade Mountains, are foster parents in
Chamberlain's program. They heardabout it from their pastor, enrolled in the program 11 years ago and learnedhow to
deal with difficult children.

"It makes so much sense," said Shannon Stone, 51, a church preschoolteacher. "Instead of dealing with one little
piece of the puzzle, we'redealing with everything."

The couple currently is trying to help a 13-year-old boy who was sexuallyabused and now is charged in juvenile court
with menacing and physicalharassment. The boy's soft brown eyes and little-kid crew cut belie a barelycontained rage,
the Stones say. He was known to lash out at the slightestprovocation.

But the boy, whose name is being withheld because of his age, is doingbetter. Last year, he was tossed out of school
35 times. This year, in a newschool, he had a 3.2 grade-point average.

Sitting on a sofa in the Stones' living room one day this year, the boy saidhe is learning to get along with those
around him.

"I'm not ready to go home," the boy said with a mischievous smile. "I stillhave a little bit of an attitude."Chan
reported from Washington.(c) 2003 The Washington Post Company

News Thursday, July 17, 2003HEROIN ADDICTS GET NEW TREATMENTOregon is to be a testing ground for the drug
therapy.SUSAN TOM Statesman Journal July 14, 2003A major push to attack Oregon's stubborn heroin problem is set to
begintoday.

Health experts are optimistic that a new treatment called buprenorphine willreach addicts in ways that standard methadone
treatment cannot.

Some of those federal and state officials will be in Portland today as partof a 14-stop tour. They chose the city
because heroin and narcotic painmedications were among the leading drugs that killed people in Portland andsurrounding
counties in 2001.

Now, help is on the way under the brand names Subutex and Suboxone. The Foodand Drug Administration has approved
the drugs for use in treatingaddictions to heroin and prescription pain relievers such as Vicodin.

Dr. Ron Schwerzler, director of medicine at Serenity Laneis Eugene clinic,predicts that methadone will be a thing
of the past in a couple of years. Healready uses buprenorphine to ease heroin withdrawal symptoms for about 20patients
and has had good results.

Buprenorphine has several advantages over methadone, the most commontreatment for heroin addiction.

Unlike methadone, which usually is dispensed in special drug treatmentclinics such as the Marion County program,
buprenorphine can be prescribedin a doctor's office.

That will make it easier for patients in remote areas who otherwise wouldhave to travel several hours to a methadone
clinic, said Jerry Gjesvold,statewide coordinator of employer services at Serenity Lane, a drugtreatment program.

Estimates are that only about 20 percent of heroin addicts are on methadone,largely because of lack of access.

"If they (recovering addicts) are not able to get to it, they'll startstreet-drug seeking," Gjesvold said.

The number of methadone clinics and the number of patients who can affordtreatment are both dwindling, the result
of state budget cuts.

Crys Morris of Albany, a 26-year-old student who has been in the MarionCounty methadone program for four years, said
she was interested in the newtherapy because of the convenience.

Although she has her own car now, Morris can remember a number of closecalls, especially during the first 90 days
of the program when she had to beat the clinic daily.

"I didn't even know if I'd even get up here," she recalled. "What do you do,hitchhike? A taxi is about $50."

The side effects of buprenorphine also are less severe than those of heroinand methadone, and there is a lower risk
of potential abuse and overdose,according to SAMHSA.

There are some restrictions, though.

Doctors are limited to 30 patients at a time and must complete eight hoursof mandatory training. Additionally, the
drug does not relieve pain, themain reason patients take prescription drugs like Vicodin.

More than 3,000 doctors have received training and more than 1,500 of themgot the OK to start prescribing the drug
to patients.

Dr. Walt Byrd, the physician at Marion County's methadone program, is one of18 Oregon doctors who have met all the
requirements.

Buprenorphine has minimal side effects and it may help some trying to getoff methadone, Byrd said, but it will never
replace methadone. He has puttwo patients on the new therapy so far and intends to prescribebuprenorphine at his private
practice in Lake Oswego.

"It's (buprenorphine) more expensive," Byrd said, comparing the new drug tomethadone. "That's one of the problems."

Gloria Thefford, the methadone clinic supervisor, agreed that addingbuprenorphine therapy is not as easy as it seems.

For starters, Marion County has to find a doctor trained in the new therapybefore the option can be offered to methadone
clinic clients.

"It's not quite the panacea many initially thought, but it has incrediblepotential," Thefford said.

Susan Tom can be reached at (503) 399-6744.

Copyright 2003 Statesman Journal, Salem, Oregon

WHAT MAKES TEENS DO DRUGSJuly 25, 2003FRIDAY, July 25 (HealthDayNews) -- Teenage boys who drink, smoke and usedrugs
are influenced more by family and friends while genes are more likelyto increase the risk of substance abuse in teenage
girls, says a VirginiaCommonwealth University study.

"Our findings show that risk factors for substance abuse are different inboys and girls," researcher Judy L. Silberg,
an assistant professor of humangenetics, says in a news release.

"In girls, there was a significant genetic influence on all substance abusein adolescence. But, with boys, environmental
factors, including adysfunctional family and peers who use drugs and alcohol, had a pervasiveinfluence," Silberg says.

She and her colleagues examined data collected over three years on 1,071adolescent twin girls and boys, aged 12 to
17, taking part in the VirginiaTwin Study of Adolescent Behavioral Development.

Their statistical analysis revealed that no single risk factor was to blamefor substance abuse in male or female
teens. In both girls and boys,genetics and environment were factors, but their degree of influence variedfor boys
and girls.

The study findings could affect the way that teens are treated for substanceabuse.

"Because girls' use of substances is controlled by the same genes that arelinked to behavioral problems, treatment
efforts that target the antisocialbehavior itself may be effective. Boys' substance use may be reduced bydirectly
altering those family and peer characteristics that are mostinfluential," Silberg says.

The study appears in the July issue of the Journal of Child Psychology andPsychiatry and Allied Disciplines .

(AP) - Black families' gains in income and education are being undermined -at least to some degree - by rising incarceration
rates and a persistentunemployment gap compared with whites, the Urban League says in its latestreport on the state
of black America.

Black families are "strong but challenged," said Urban League President MarcMorial. "More black families are counted
to be middle income, the number ofblack businesses are up. But then on the other hand, a higher proportion ofblack
men are in jail and the black unemployment rate, after decliningsignificantly, is back up."

The annual report, scheduled for formal release Wednesday, is a collectionof nine essays written by experts in race,
social justice, health,psychology and civil rights. Black families have been a recurring themesince it was first published
in 1976.

Three decades after he first wrote about black families for the UrbanLeague, Robert Hill, a senior researcher at
the Rockville, Md., researchfirm Westat, examines how the social and economic status of black familieshas changed.

Racism remains, he writes. In the last 30 years, "there has been a strongshift from Jim Crow - the overt manifestation
of racial hatred byindividuals and white society - to James Crow, Esquire - the maintenance ofracial inequality through
covert processes of structure and institutions,"he says.

Though blacks are no more likely than whites to mistreat their children,they are over-represented in the foster care
system, he says. Nationally,black children comprise about one in five children, but account for almosthalf of the
550,000 in foster care.

Teen pregnancy contributes to the instability of black families - blackteens are about three times more likely than
whites to have out-of-wedlockbabies, Hill says. Other factors which have hurt black families, he says,include: urban
renewal efforts, which displaced many blacks and createdsegregated high-rise public housing; drug use, and the AIDS epidemic.

Economically, a decline in manufacturing and the rise of service industriesmeant many black workers went from higher-paying
blue-collar jobs to muchlower-paying white-collar service jobs, he says.

Blacks have made little progress in narrowing the jobless gap with whites.In June, the national unemployment rate
for whites was 5.5 percent; forblacks, 11.8 percent. In 1972, the jobless rate among whites was 5.1percent; for blacks,
10.4 percent.

And while black families' median income increased, it still remains at only60 percent of white families', Hill says.

But black families also have demonstrated continued strengths through theirstrong desire to see children go to college,
work ethic, support provided byextended family members and their religious faith, which has helped upwardmobility
among blacks, Hill says.

Other essays in the report focus on stresses to black families, including:

- An increase in the black population in prisons. Though blacks make upabout 12 percent of the nation's population,
they account for nearly half ofthe people in prison, says Ernest Drucker, author of an essay onincarceration.

That divides families - more than half of incarcerated men have children whoare minors, Drucker says.

The incarceration disparities have been fueled by drug enforcement policiesthat have harsher effects on blacks, says
James Lanier of the Urban League'sInstitute for Opportunity and Equality. He cites data showing that blacksaccount
for 13 percent of the nation's drug users, but 35 percent of drugarrests and 53 percent of drug convictions.

- A child care shortage that is especially prevalent in poor, urban countieswhere many blacks live.

- Lesbian, gay, bisexual and transgender families are an integral part ofthe black community but are still not recognized
by some. About 40 percentof women, 18 percent of men and 15 percent of transgender people surveyed atBlack Pride celebrations
in nine cities said they had at least one child.

The report, which also includes essays on black feminism, black girls andtheir families, the legacy of sociologist
E. Franklin Frazier and a specialsection on affirmative action, is to be released at a news conference inWashington.

Cannabis link to psychosisSarah Boseley, health editor Thursday July 3, 2003 The GuardianVery heavy use of
cannabis could be a cause of psychosis, accordingto a leading psychiatrist who believes that society should thinkcarefully
about the potential consequences of its increasing use.

Robin Murray, professor of psychiatry at the Institute of Psychiatryand consultant psychiatrist at the Maudsley hospital
in London, saysthat in the last 18 months, there has been increasing evidence thatcannabis causes serious mental illness.
In particular, a Dutch studyof 4,000 people from the general population found that those takinglarge amounts of cannabis
were almost seven times more likely to havepsychotic symptoms three years later.

"This research must not be ignored," said Prof Murray, speaking atthe annual general meeting of the Royal College
of Psychiatrists inEdinburgh.

Writing in the Guardian last August, Prof Murray said he had beensurprised that the discussion around cannabis had
skirted around theissue of psychosis.

Psychiatrists had known for 150 years that very heavy consumption ofcannabis could cause hallucinations and delusions.

"This was thought to be very rare and transient until the 1980s when,as cannabis consumption rose across Europe and
the USA, it becameapparent that people with chronic psychotic illnesses were morelikely to be regular daily consumers
of cannabis than the generalpopulation."

In the UK, he said, people with schizophrenia are about twice aslikely to smoke cannabis. The reason appears to be
the effect thatthe drugs have on chemicals in the brain. "In schizophrenia, thehallucinations and delusions result
from an excess of a brainchemical called dopamine. All the drugs which are known to causepsychosis - amphetamine,
cocaine and cannabis -increase the releaseof dopamine in the brain."

Cannabis had been the downfall of many a promising student, hesuggested. "Like any practising psychiatrist, I have
often listenedto the distraught parents of a young man diagnosed with schizophreniatell me that as a child their son
was very bright and had no obviouspsychological problems. Then in his mid-teens his grades beganfalling. He started
complaining that his friends were against him andthat people were talking about him behind his back.

"After several years of increasingly bizarre behaviour, he droppedout of school, job or university; he was admitted
to a psychiatricunit overwhelmed by paranoid fears and persecution by voices. Theparents tell me that, at some point,
their son was heavily dependenton cannabis."

It used to be thought that the high numbers of psychotic patientstaking cannabis could be explained because they
used it to alleviatetheir symptoms. The recent studies, however, have looked at largepopulations without mental illness
and studied the numbers ofcannabis takers within them who have developed psychosis.

STUDY: POT DOESN'T CAUSE PERMANENT BRAIN DAMAGEFri Jun 27,12:18 AM ETBy Deena BeasleyLOS ANGELES (Reuters)
- Smoking marijuana will certainly affectperception, but it does not cause permanent brain damage, researchersfrom
the University of California at San Diego said on Friday in astudy.

"The findings were kind of a surprise. One might have expected to seemore impairment of higher mental function,"
said Dr. Igor Grant, aUCSD professor of psychiatry and the study's lead author. Otherillegal drugs, or even alcohol,
can cause brain damage.

His team analyzed data from 15 previously published, controlledstudies into the impact of long-term, recreational
cannabis use on theneurocognitive ability of adults.

The studies tested the mental functions of routine pot smokers, butnot while they were actually high, Grant said.

The results, published in the July issue of the Journal of theInternational Neuropsychological Society, show that
marijuana has onlya marginally harmful long-term effect on learning and memory.

No effect at all was seen on other functions, including reaction time,attention, language, reasoning ability, and
perceptual and motorskills.

Grant said the findings are particularly significant amid questionsabout marijuana's long-term toxicity now that
several states areconsidering whether to make it available as a medicinal drug.

In California, growing marijuana for medical purposes is legal under avoter-approved law.

The UCSD analysis of studies involving 704 long-term cannabis usersand 484 nonusers was sponsored by a state-supported
program thatoversees research into the use of cannabis to treat certain diseases.

Anecdotal evidence has shown that marijuana can help ease pain inpatients with diseases like multiple sclerosis or
prevent severenausea in cancer patients, but the effects have yet to be proven incontrolled studies, Grant said.

The UCSD research team said the problems observed in learning andforgetting suggest that long-term marijuana use
results in selectivememory defects, but said the impact was of a very small magnitude.

"If we barely find this tiny effect in long-term heavy users ofcannabis, then we are unlikely to see deleterious
side effects inindividuals who receive cannabis for a short time in a medicalsetting," Grant said.

In addition, he noted that heavy marijuana users often abuse otherdrugs, such as alcohol and amphetamines, which
also might havelong-term neurological effects.

Some of the research studies used in the analysis were limited by thenumbers of subjects or insufficient information
about factors likeexposure to other drugs or whether participants suffered fromconditions like depression or personality
disorders.

"If it turned out that new studies find that cannabis is helpful intreating some medical conditions, this enables
us to see a marginallevel of safety," Grant said.

MANY GAY, BISEXUAL MEN REPORT UNSAFE SEX: STUDYTue June 24, 2003 06:21 PM ETNEW YORK (Reuters Health) - A
large percentage of gay andbisexual men say they have had unsafe sex in recent months, puttingthemselves at risk of
HIV and other sexually transmitted diseases, anew study has found.

Among nearly 4,300 gay or bisexual men in six U.S. cities, around halfsaid they had had unprotected anal sex during
the past six months,researchers report in the American Journal of Public Health.

The findings "emphasize the continued need for effective behavioralstrategies designed to prevent HIV infection among
men who have sexwith men," write Dr. Beryl A. Koblin, of the New York Blood Center inNew York City, and colleagues.

Their results are based on interviews with 4,295 gay or bisexual menparticipating in the ongoing EXPLORE study, which
is aiming toidentify risk behaviors that may be fueling HIV transmission in theU.S.

Every six months the study participants undergo counseling regardingtheir sexual behavior and get tested for HIV
and other STDs.

All of the men were HIV-negative at the start of the study andreported that they had had anal sex during the six
months prior to thestudy, which began in 1999.

Overall, men who said they'd had multiple sexual partners in recentmonths were no more likely to have used a condom
than those who saidthey had only one primary partner -- a finding Koblin's team says is"of particular concern" since
the former group is at increased STDrisk.

In addition, unprotected anal sex was much more common when drugs andalcohol were involved, the researchers found.

The HIV epidemic among gay and bisexual men in the U.S. "continues tobe a major public health issue," Koblin's team
writes.

"Our findings," they conclude, "support the continued need foreffective intervention strategies for men who have
sex with men thataddress relationship status, (HIV status) of partners and drug andalcohol use."

SOURCE: American Journal of Public Health 2003:93:926-932.

Yale UniversityAdolescents are neurologically more vulnerable to addictionsNew Haven, Conn. -- Adolescents
are more vulnerable than any otherage group to developing nicotine, alcohol and other drug addictionsbecause the regions
of the brain that govern impulse and motivationare not yet fully formed, Yale researchers have found.

After conducting an analysis of more than 140 research studies fromacross the basic and clinical neurosciences, including
many conductedat Yale, the researchers concluded that substance use disorders infact constitute neurodevelopmental
disorders.

"Several lines of evidence suggest that sociocultural aspectsparticular to adolescent life alone do not fully account
for greaterdrug intake," said Andrew Chambers, M.D., assistant professor ofpsychiatry at Yale School of Medicine and
lead author of the studypublished this month in the American Journal of Psychiatry. "Andwhile we strongly suspect
that genetic factors in individuals canlower the threshold of drug exposure required for 'tripping theswitch' from
experimental to addictive drug use, here we have aphenomena where a neurodevelopmental stage common to virtuallyeveryone
regardless of genetic make-up confers enhancedneurobiological vulnerability to addiction."

Chambers said that this perspective is possible when viewing brainsystems involved in motivation and addiction as
distributedcomponents that undergo unique developmental histories.

"Particular sets of brain circuits involved in the development ofaddictions are the same ones that are rapidly undergoing
changeduring adolescence," he said. "Normally these processes causeadolescents to be more driven than children or
adults to have newexperiences. But these conditions also reflect a less matureneurological system of inhibition, which
leads to impulsive actionsand risky behaviors, including experimentation and abuse of addictivedrugs."

"Because of developmental changes in brain regions concerned with theformation of adult motivations, the actions
of drugs in those regionsto cause addiction may occur more rapidly and potentially withgreater permanency," Chambers
said.

He said the implications of this review are that addictions should beviewed as developmental disorders and that researchers
shouldconcentrate on the adolescent period when considering treatment andprevention of addictions. Also, it highlights
the importance ofresearching the impact of current psychotropic medication treatmentpractices in childhood and adolescence
on the incidence of addictionsin adulthood.

"The identification of adolescent subgroups with heightenedvulnerability to substance abuse disorders, development
ofevidence-based preventative strategies, and refinement ofpharmacotherapeutic and psychosocial treatments are important
areasto pursue in order to reduce the large impact of substance usedisorders upon society," he said.###

Co-authors included Jane Taylor and Marc Potenza, M.D., both in theDepartment of Psychiatry.

The study was supported by a Veterans Administration SpecialNeuroscience Research Fellowship Grant and grants from
the NationalAlliance for Research on Schizophrenia and Depression, the NationalInstitute on Drug Abuse, the American
Psychiatric Association and theNational Center for Responsible Gaming.

Locked up in land of the freeInmates: The United States has surpassed Russia as the nation with the highest percentage
of citizens behind bars.By Scott Shane Originally published Jun 1, 2003 With a record-setting 2 million people locked
up in American jails and prisons, the United States has overtaken Russia and has a higher percentage of its citizens behind
bars than any other country. Those are the latest dreary milestones resulting from a two-decade imprisonment boom that
experts say has probably helped reduce crime but has also created ballooning costs and stark racial inequities. Overseas,
U.S. imprisonment policy is widely seen as a blot on a society that prides itself on valuing liberty and just went to war
to overturn Saddam Hussein's despotic rule in Iraq. "Why, in the land of the free, should 2 million men, women and children
be locked up?" asks Andrew Coyle, director of the International Centre for Prison Studies at the University of London and
a leading authority on incarceration. When he discusses crime and punishment with foreign colleagues, Coyle says, the
United States is such an anomaly that it must often be left out of the discussion. "People say, 'Well, that's the United States.'
They see the U.S. as standing entirely on its own," he says. The latest statistics support that view. The new high of
2,019,234, announced by the Justice Department in April, underscores the extraordinary scale of imprisonment in the United
States compared with that in most of the world. During the 1990s, the United States and Russia vied for the dubious position
of the highest incarceration rate on the planet. But in the past few years, Russian authorities have carried out large-scale
amnesties to ease crowding in disease-infested prisons, and the United States has emerged unchallenged into first place, at
702 prisoners per 100,000 population. Russia has 665 prisoners per 100,000. Today the United States imprisons at a far
greater rate not only than other developed Western nations do, but also than impoverished and authoritarian countries do.
On a per capita basis, according to the best available figures, the United States has three times more prisoners than
Iran, four times more than Poland, five times more than Tanzania and seven times more than Germany. Maryland has more citizens
in prison and jail (an estimated 35,200) than all of Canada (31,600), though Canada's population is six times greater. "This
is a pretty serious experiment we've been engaged in," says Vincent Schiraldi, director of the Justice Policy Institute, a
Washington think tank that supports alternatives to prison. "I don't think history will judge us kindly." Bruce Western,
a sociologist at Princeton University, says sentencing policies have had a glaringly disproportionate impact on black men.
The Justice Department reports that one in eight black men in their 20s and early 30s were behind bars last year, compared
with one in 63 white men. A black man has a one-in-three chance of going to prison, the department says. For black male
high school dropouts, Western says, the numbers are higher: 41 percent of black dropouts between ages 22 and 30 were locked
up in 1999. "I think this is one of the most important developments in race relations in the last 30 years," he says.
Some conservative analysts say that however regrettable the prison boom has been, it's working. It's no anomaly that the
prison population is still rising despite a decade-long fall in the national crime rate, they say, but rather cause and effect.
"If you put someone in prison, you can be sure they're not going to rob you," says David B. Muhlhausen, a policy analyst
at the Heritage Foundation. "Quality research shows that ... increasing incarceration decreases crime." Considering that there
are still about 12 million serious crimes a year, Muhlhausen says, "maybe we're not incarcerating enough people." Miscreants
have been locked up for centuries, but today's prisons are the legacy of 19th-century reformers' desire to rehabilitate wrongdoers
rather than punish them with whipping, dunking in water or being displayed in public stocks. Quaker influence was behind
the creation in 1829 of Philadelphia's Eastern State Penitentiary, often considered the first modern American prison. It took
a century and a half, until 1980, to reach 500,000 inmates. Then, in slightly more than 20 years, the prison and jail population
grew by 1.5 million. A major cause of the increase is the war on drugs. In 1980, says Marc Mauer, assistant director of
the Sentencing Project in Washington, about 40,000 Americans were locked up solely for drug offenses. Now the number is 450,000,
three-fourths of them black or Hispanic, although drug use is no higher in those groups than among whites. "Drug abuse
cuts across class and race," says Mauer, author of Race to Incarcerate. "But drug law enforcement is focused on low-income
neighborhoods." Alfred Blumstein, a criminologist at Carnegie-Mellon University, says locking up drug dealers does not
necessarily reduce their number, because new recruits quickly take their place. The well-established penal theory of "incapacitation,"
Blumstein says, dictates that "if a guy's committing 10 crimes a year and you lock him up for two years, you've prevented
20 crimes," Blumstein says. "That works for rape and robbery. But with drugs, there's a resilient market out there. The incarceration
of drug offenders is largely an exercise in futility." A second major reason for the rise in imprisonment is the politically
popular shift to longer sentences with mandatory minimums, "three-strikes" laws and "truth-in-sentencing" measures to eliminate
early parole. "Since the 1970s, there's been a growing politicization of punishment policy," Blumstein says. "It's the
30-second sound bite of the prison door slamming, with the implicit promise, 'Vote for me and I'll slam the door.'" A tough
stance on sentencing usually wins votes, whether or not it ultimately reduces crime. Blumstein says the most rigorous
recent studies suggest that about 25 percent of the drop in crime in recent years resulted from locking up more criminals.
The rest resulted from other factors, among them the ebbing of the crack cocaine epidemic, changed policing strategies and
the strong economy of the 1990s. Now, with many state budgets in crisis, there are hints of a turnaround. Justice Department
figures show that nine states reduced their prison populations last year, including Texas, Illinois and New York. The
number of prisoners was still rising in far more states, including Maryland, where the prison population - excluding jails
- has more than tripled since 1980, to about 24,000. But many governors and legislators are wondering whether they can
afford to house more and more offenders at an average of $25,000 a year apiece. "Even some of your more right-wing people
are saying, 'Let's see what we can do to get some people out of prison to save some money,'" says Reginald A. Wilkinson, director
of the Ohio Department of Rehabilitation and Correction and president of the association of state prison chiefs. Like
many prison professionals, Wilkinson says, "I always thought we locked up too many people." He says he's taking advantage
of the budget squeeze to push for cheaper alternatives. Ohio's state prison population has fallen from its 1998 high of 49,000
to 45,000, and two prisons have been closed, he says. In Maryland, there's no talk of closing prisons. Major expansions
are planned or under way at North Branch Correctional Institution near Cumberland and Eastern Correctional Institution on
the Eastern Shore to add 396 beds to the crowded system. "Maryland would seem to be stuck in neutral," says Judith A.
Greene, a senior fellow at the Justice Policy Institute who has tracked the beginning of a turnaround in other states. Gov.
Robert L. Ehrlich Jr. and his secretary of public safety and correctional services, Mary Ann Saar, have said they want to
use drug treatment and closer supervision of parolees to keep former offenders from returning to prison. Saar's planned
programs "all have the goal of getting people out of prison and keeping them out," says Mark A. Vernarelli, director of public
information for the department of public safety. Still, he adds, given the steady flow of prisoners sent by the courts, "we
maintain a constant vigil for land for new prisons."

Reported June 6, 2003Substance Use Among Teens(Ivanhoe Newswire) -- Researchers know high levels of drug
and alcoholuse in teens can lead to psychiatric problems. Now, a new study showslower levels of use are cause for
concern as well.

Investigators believe this result, outlined in the current issue ofPediatrics, points to a greater need to identify
substance use amongteenagers during primary care physician visits.

The study was conducted among about 500 teens aged 14 to 18 years whowere receiving routine care in an adolescent
clinic. All teenscompleted standard screenings aimed at gauging their level ofsubstance use and the presence of psychiatric
symptoms. The teens wereclassified into three groups according to their use of drugs andalcohol: those who weren't
using substances or had no problems withthem (66 percent), those who were using substances and having someproblems
(18 percent), and those diagnosed with substance usedisorders (16 percent).

At least one type of psychiatric problem was noted in 80 percent ofall the teenagers, with symptoms of anxiety being
the most common inboth boys and girls. When compared with the nonproblematic group,however, results showed teens with
either substance use problems ordisorders were more likely to suffer several psychiatric problems.Girls with substance
use problems or disorders were more likely toreport symptoms of mania, attention deficit disorder, and conductdisorder.
Girls with disorders had an increased risk of depression,eating disorders, and hallucinations or delusions.

Boys with substance use problems were more likely to have attentiondeficit disorder symptoms, and boys identified
with substance usedisorders had a greater risk of hallucinations or delusions. Boys inboth substance use categories
were more likely to report conductdisorder symptoms.

Overall, both boys and girls with substance use problems or disordersare at increased risk for higher psychiatric
symptom scores and awider range of psychiatric symptoms than those who aren't having anyproblems with substance use.

This article was reported by Ivanhoe.com, who offers Medical Alerts bye-mail every day of the week. To subscribe,
go to:http://www.ivanhoe.com/newsalert/.SOURCE: Pediatrics, 2003;111:699-705

Monday, June 2, 2003 Brown University News ServiceContact: Scott Turner mailto:News_Service@brown.eduNICOTINE CHANGES NEWBORN BEHAVIOR SIMILAR TO HEROIN AND CRACKFor the first time, researchers report that nicotine
exposure in thewomb produces behavioral changes in babies similar to those found innewborns of women who use crack
cocaine or heroin during pregnancy.The study by Brown Medical School researchers appears in the Juneissue of Pediatrics. PROVIDENCE,
R.I. A new study suggests that even casual smokingduring pregnancy harms a fetus, producing behavioral changes similarto
those in babies born to mothers who use illegal drugs.

Women who smoke just 6 to 7 cigarettes per day give birth to babieswho are more jittery, more excitable, stiffer
and more difficult toconsole than newborns of nonsmokers, report Brown Medical Schoolresearchers in the June issue
of the journal Pediatrics. The higherthe dose of nicotine measured in a mother, the greater the signs ofstress in
her new baby.

This is the first research paper to show that nicotine exposure in thewomb produces behavioral changes in babies
similar to those found innewborns of women who use crack cocaine or heroin while pregnant. Thedata suggest "neonatal
withdrawal" from nicotine, said the authors.

"We have a legal drug in nicotine that may have the same toxic effectas illegal drugs," said Karen L. Law, who led
the study. Law suggeststhat public health officials consider stop-smoking interventions thatwould produce healthy
newborns for women who currently smoke.

"These findings require us to take a step back," she said. "What areSurgeon General warnings doing to stop smoking,
given that thepercentage of smokers is similar in the pregnant and generalpopulations (about 18 percent and 25 percent
respectively)? It is ahuge public health concern that so many people are suffering the costsof smoking, including
newborns."

Brown researchers are conducting a follow-up study of tobacco-exposedinfants in their first month of life to better
understand thelingering effects from nicotine.

Previous research has linked as few as 10 cigarettes daily duringpregnancy to low birth weight babies. The Brown
study lowers thethreshold for causing fetal impairment to 6 to 7 cigarettes a day.This new study opens the door to
further research, said Law. "We don'tknow if a woman quits smoking six months into pregnancy will that makea difference?
Given that we have found a behavioral outcome innewborns at a lower dose of six cigarettes a day, would we find aneffect
at three cigarettes as well?"

To some extent, "this is science shaped by culture," said BarryLester, senior author of the study and an expert on
maternal drugexposure. "We tolerate smoking in ways that we don't tolerate drugs.Eighteen percent of women smoke in
pregnancy. About 3 to 5 percent ofpregnant women use cocaine. Yet everyone is worried about cocaine."

If cigarettes cause a fetus the same injury as illegal drugs, "do weyank newborn babies from women who smoked during
pregnancy?" Lestersaid. "Here, a legal drug is showing the same effects as an illegalsubstance for which protective
services will remove babies from theirmothers. We have not faced this policy question about a legal drugbefore, because
this scientific information was not available. We needto re-look at how we evaluate a fit mother."

Tobacco-exposed babies could flourish, with the proper child rearing,said Lester. "You have to apply the findings
in context," he said."Yes, this is correctable. If a behaviorally vulnerable baby receivesattention and care, there
is no reason to think that the child won'tthrive. But we also know that the same baby is at risk for a poordevelopmental
outcome if that child grows up in a stressed, low-incomeenvironment, where effects of exposure get exaggerated."

To conduct the study, Law collected self-reports of smoking from newmothers. She correlated the information with
a biological marker ofnicotine, called cotinine, collected from saliva of the mothers. Thisis the first study of its
kind to include cotinine. Law also conducteda behavioral exam for newborns within 48 hours of birth, designed tomeasure
drug effects. Women were excluded from the study for use ofillegal drugs, antidepressants and alcohol. All babies were
full-term,and the researchers controlled for low birth-weight and other factors.

Law conducted the study as a senior at Brown, where she is now athird-year medical student. She led a six-member
team of specialistsin infant development, addiction behavior and smoking cessation. Thestudy was supported in part
by a Brown Medical School Summer ResearchFellowship and by grants from the National Cancer Institute and theDepartment
of Psychiatry and Human Behavior at the Brown MedicalSchool.

Behavioral treatment may reverse brain changes that occur withcocaine use and help prevent relapseNIH/National
Institute on Drug AbuseBrain changes that occur with cocaine use and the tendency towardrelapse may be reduced by
a behavioral treatment using extinctiontraining--a form of conditioning that removes the reward associatedwith a learned
behavior. NIDA-funded researchers found thatextinction training during cocaine withdrawal produces changes inbrain
receptors for glutamate, a brain chemical found in the nucleusaccumbens, the reward center of the brain. A reduction in
glutamateinput from cortical brain regions by chronic cocaine use is thoughtto contribute to persistent cravings for
the drug.

The researchers trained rats to self-administer cocaine by pressing alever and to associate the availability of cocaine
with certainenvironmental cues (lights and noise). Once the rats had learned toexpect cocaine when they pressed the
lever, cocaine and the cues wereremoved so that the rats did not receive the cocaine that they wereanticipating. One
group of rats received this extinction trainingduring cocaine withdrawal while another group did not receive thetraining.
After extinction training was over, the researchers exposedthe rats to the cocaine-associated cues and administered cocaine
toinduce relapse.

The researchers found that the rats given extinction training duringwithdrawal had more than a 30 percent increase
in glutamate receptorsin the outer regions of their nucleus accumbens. The number ofglutamate receptors did not increase
in rats that did not receive thetraining during withdrawal. When cocaine-related cues werereinstated, rats showing
relatively no response to these stimuli hada greater increase in receptors than rats that responded to the cues.

WHAT IT MEANS: These findings indicate that behavioral-basedtreatment approaches have the potential to reverse or
lessen theharmful neurobiological and behavioral consequences of chronic druguse. Increasing the number of glutamate
receptors may help easecravings for cocaine during abstinence and also help prevent relapse.

This study was published by lead investigator Dr. David Self at theUniversity of Texas Southwestern Medical Center
in the January issueof Nature.

Drug Study Promising for Heavy DrinkersThe Washington Post - May 16, 2003 A drug with a novel mechanism of action
reduced the craving for alcohol among heavy drinkers and may help alcoholics quit or seriously reduce their drinking,
researchers reported yesterday.

The medicine, topiramate, which is marketed to control seizures, was found to be effective in a trial with 150 volunteers
conducted at the University of Texas at San Antonio, said lead investigator Bankole Johnson, a psychiatrist.

"We think it's very significant," he said in an interview. In a comparison of those taking the drug with those
receiving placebo pills and behavioral counseling, the drug "is four times better in terms of heavy drinking and eight
times better in terms of complete abstinence."

The Food and Drug Administration has not approved the medicine, which appears to affect the brain's ability to experience
the pleasure of drinking and to reduce the craving for alcohol, for treating alcoholism. The study would have to be
replicated in larger groups before doctors could recommend it.

Still, federal researchers and others agreed that it could open a new front in the treatment of alcohol abuse, which
afflicts about 14 million Americans -- one in every 13 adults. Alcohol abusers are defined as men who have five or
more drinks per day and women who have four or more drinks each day.

Unlike traditional alcohol abuse studies, which usually examine the effectiveness of medicines and psychological
interventions in keeping alcoholics from drinking at all, Johnson's study involved volunteers who were active heavy
drinkers. The results were published in the Lancet medical journal.

"The results were very promising," said Raye Litten, chief of the Treatment Research Branch at the National Institute
on Alcohol Abuse and Alcoholism.

Large studies are underway to measure the effects of combining other medications with a range of psychosocial therapies.

Topiramate may be especially effective in easing the symptoms of withdrawal, said Robert Swift, an alcohol abuse
researcher at Brown University.

Doctors believe that most alcoholics require treatment with multiple approaches, including other medicines and psychological
or religious techniques, to quit drinking and stay sober. Since many alcoholics go back to the bottle, doctors have
come to mark victory against alcohol abuse in modest terms -- keeping people sober for periods of time rather than expecting
them to quit permanently.

"Alcoholism is not a homogenous disease, so there is no magic bullet out there to treat" it, Litten said. "There
is a biological component and a psychological component and a cultural component and a social component, and they
vary from individual to individual."

Two medicines are approved to treat alcohol abuse -- disulfiram, sold under the trade name Antabuse, makes drinkers
feel sick if they drink, while the better known naltrexone, sold as ReVia or Depade, appears to reduce the pleasure
in drinking, Swift said.

Johnson pointed out that all the patients taking topiramate in his study -- even those still drinking -- were no
longer consuming dangerous amounts of alcohol.

"We are able to get practically everybody drinking close to nothing, and the ones who are still drinking are not
drinking as much," he said.

The study measured the effectiveness of topiramate -- which is sold under the brand name Topamax -- among 150 heavy
drinkers. Half received the medicine and low-intensity counseling, while the other half received placebo pills and the
same counseling.

The average person in the topiramate group was drinking 9.59 drinks a day upon beginning the study, compared with
8.85 drinks a day in the placebo group. Participants were asked to keep track of how much they drank, and even before
they began taking medication their consumption dropped dramatically -- an indication of the role social factors play in
alcohol abuse.

By the end of the three-month trial, patients taking topiramate were down to 1.5 drinks a day, while those taking
the placebo were down to 3.36 drinks a day.

Johnson said 13 or 14 patients in the topiramate group quit entirely and stayed sober, while only two from the placebo
group stopped drinking altogether.

Topiramate is sold in the United States by Ortho-McNeil Pharmaceutical of Raritan, N.J., which provided the pills
and some funding. Most of the funding came from Johnson's own department. The researcher said he owns no stock in the
company and would not financially benefit if the FDA approved the medicine for treating alcohol abuse.

Stephanie Scott, a spokeswoman for the company, said, "Right now, all we can say is the results are promising and
would warrant some future investigation. We are not actively pursuing an indication for alcoholism for this compound."

Johnson's study did not report any severe side effects, but a recent study of topiramate in epileptics, conducted
by Kimford J. Meador, chairman of the Neurology Department at Georgetown University Medical Center, found that some experienced
severe side effects unless they started at low doses and built up gradually.

Contact: Hannelore Ehrenreich, M.D., D.V.M. ehrenreich@em.mpg.de49-551-3899628 (Germany) Max-Planck-Institute for Experimental MedicineAdd'l Contact: Claudia Spies, M.D. claudia.spies@charite.de 49-30-450-531052(Germany) University Hospital Charite Campus MitteCHRONIC ALCOHOL ABUSE DAMAGES REGULATING HORMONES*
Chronic alcohol consumption is associated with higher rates of infections,cardiomyopathy, cardiac arrhythmias, bleeding
complications and liverinsufficiency.* Alcohol withdrawal and early abstinence also wreak havoc on alcoholics.*
New research indicates that changes in hormones that regulate electrolyteand water balance in the body may not only account
for some withdrawalsymptoms but persist over long periods of strictly controlled abstinence.

Although it is well known that chronic alcohol abuse causes a broad range ofhealth complications, it remains unclear
how much regeneration may occurduring long-term abstinence from alcohol. A new study carefully monitorsmajor water
and electrolyte regulating hormones - arginine vasopressin(AVP), atrial natriuretic peptide (ANP), aldosterone and angiotensin
II -from early withdrawal up to 280 days of strict abstinence. The results,published in the May issue of Alcoholism:
Clinical & Experimental Research,indicate that chronic alcohol abuse can cause severe and persistentalterations
in the hormones that regulate electrolyte and water balance inthe body.

"Most of the available literature on regeneration from alcoholism isrestricted to the first few days up to three
weeks of abstinence," saidHannelore Ehrenreich, head of Clinical Neuroscience at theMax-Planck-Institute for Experimental
Medicine and corresponding author forthe study. "Only rarely do papers report on persistent alterations or onpatterns
of regeneration associated with long-term abstinence. In fact, manydisturbances are believed - but never proven - to return
to normal within afew weeks."

"Both chronic alcohol consumption and alcohol withdrawal can affect cell andhomeostatic functions on a variety of
levels," said Claudia Spies, medicalassociate director of the department of anesthesiology and intensive caremedicine
at the University Hospital Charite Campus Mitte. "A chronic alcoholintake of at least 60g, or 1.5l beer, per day is associated
with severecomplications such as higher rates of infections, cardiomyopathy, cardiacarrhythmias, bleeding complications
and liver insufficiency. Duringwithdrawal, changes in electrolyte and water homeostasis occur. We know thatthe interaction
of different homeostatic systems is complex but thespecifics are poorly understood."

The consequences, however, are clear. "The hospital stay of alcoholics isprolonged compared with that of non-alcoholics,"
said Spies. "A majorcomplication is alcohol withdrawal syndrome (AWS), developed byapproximately half of chronic alcoholics
during their hospital stay. Themajority of the patients who develop AWS have hallucinations or delirium.AWS can also
be deadly. In one study, the mortality rate in patients withAWS was approximately 18 percent, whereas alcohol abusers
without AWS had amortality rate of four to six percent, and non-alcohol abusers had amortality rate of zero percent."

The study authors knew from previous research that various components of thephysical and psychological stress-response
systems can sustain damagedespite many months of abstinence. "Vasopressin, or AVP, is a hormone thatis also part of
the stress regulatory system," said Ehrenreich. "In previouswork, we showed that circulating levels of AVP are persistently
suppressedin alcoholic patients over many weeks of abstinence. This is why we chose tofurther elucidate the recovery
of vasopressin levels in alcoholics duringlong-term abstinence. Since atrial natriuretic peptide, or ANP, as well asaldosterone
and angiotensin II are counter-regulatory or counterbalancinghormones to AVP, it was logical to simultaneously follow
these parameters ofwater/electrolyte homeostasis."

Two groups of males participated in this study: alcoholics (n=35), 30 to61years of age; and controls (n=20), 25 to
50 years of age. The two groupswere matched on cigarette use. "It is well known that acute nicotineincreases the secretion
of AVP," explained Ehrenreich. "It has to be assumedthat chronic cigarette consumption also alters AVP secretion or metabolism.Therefore,
we used cigarette-matched controls in order to exclude theinfluence of such an interfering variable."

Following an inpatient detoxification period of two to three weeks, 21 ofthe 35 alcoholics were successfully monitored
for the full length of thestudy period, 280 days. Researchers collected data from all of theparticipants on their
AVP, ANP, aldosterone, and angiotensin II levels, aswell as measures of kidney and liver function.

They found that basal AVP levels were suppressed during the entire studyperiod. In contrast, ANP levels were elevated
for the entire time. Nopersistent alterations were found for aldosterone or angiotensin II.

"We learned that we are dealing with profound, long-lasting alterations ofkey hormones of water and electrolyte balance
notwithstanding at least ninemonths of controlled abstinence," said Ehrenreich. "These observations implya number
of causes and consequences: they may explain excessive thirst andfluid intake, what we call diabetes insipidus; may explain
howalcohol-related cardiomyopathy develops; and may show that there is asubclinically impaired renal function in these
patients which clearlyunderlines the concept of multi-organ involvement in alcoholism, that is,not only are the liver
and brain affected, but basically all organs are."

Both Ehrenreich and Spies believe these results can be used to develop newtherapeutic options to support abstinence
in alcoholics.

"One possibility would be to substitute AVP," said Ehrenreich, "which mightnot only contribute to recovery of water
and electrolyte homeostasis butalso benefit cognitive functions such as memory. The findings of the presentstudy imply
that at least some features of craving, such as drinkingbehaviour and thirst, might be explained by biological alterations
in theregulation of salt and water homeostasis. Therefore, approaches tosubstitute for vasopressin, or to normalize
vasopressin regulation, mightresult in a reduction of craving-induced relapses."

Ehrenreich added that one of the most important findings of this study isthat "chronic alcoholism is associated with
long-term persistent alterationsof various organs and systems even with controlled abstinence. There is noimmediate
recovery to be expected," she stressed.

"Both for psychological as well as medical reasons, we need to consider thatwe are dealing with individuals severely
compromised over many months ofcontrolled abstinence. Detoxification treatments are important and necessaryto overcome
life-threatening withdrawal symptoms, but with respect toorganic and psychological alterations in this group of patients,
they onlyreach the tip of the iceberg."

Alcoholism: Clinical & Experimental Research (ACER) is the official journalof the Research Society on Alcoholism
and the International Society forBiomedical Research on Alcoholism. Co-authors of the ACER paper included:Wolf K.H.
Doering, Marie-Noelle Herzenstiel, Henning Krampe, Henriette Jahn,and Sonja Sieg of the Departments of Psychiatry and
Neurology atGeorg-August-University, and of Max-Planck-Institute for ExperimentalMedicine in Goettingen, Germany;
Lars Pralle of the Department of MedicalStatistics at Georg-August-University; Elisabeth Wegerle of the Departmentof
Clinical Pharmacology at Georg-August-University; and Wolfgang Poser ofthe Departments of Psychiatry, Neurology, and Clinical
Pharmacology atGeorg-August-University. The study was funded by the Max-Planck-Society.

Study Finds No Sign That Testing Deters Students' Drug UseMay 17, 2003By GREG WINTER - - NY TimesDrug
testing in schools does not deter student drug use anymore than doing no screening at all, the first large-scalenational
study on the subject has found.

The United States Supreme Court has twice empowered schoolsto test for drugs - first among student athletes in 1995,then
for those in other extracurricular activities lastyear. Both times, it cited the role that screening plays incombating
substance abuse as a rationale for impinging onwhatever privacy rights students might have.

But the new federally financed study of 76,000 studentsnationwide, by far the largest to date, found that drug useis
just as common in schools with testing as in thosewithout it.

"It suggests that there really isn't an impact from drugtesting as practiced," Dr. Lloyd D. Johnston, a studyresearcher
from the University of Michigan, said. "It's thekind of intervention that doesn't win the hearts and mindsof children.
I don't think it brings about any constructivechanges in their attitudes about drugs or their belief inthe dangers
associated with using them."

The prevalence of drug use in schools that tested for drugsand those that did not was so similar that it surprised
theresearchers, who have been paid by the government to trackstudent behavior for nearly 30 years and whose data on
druguse is considered highly reliable.

The study, published last month in The Journal of SchoolHealth, a peer-reviewed publication of the American SchoolHealth
Association, found that 37 percent of 12th gradersin schools that tested for drugs said they had smokedmarijuana in
the last year, compared with 36 percent inschools that did not. In a universe of tens of thousands ofstudents, such
a slight deviation is statisticallyinsignificant, and it means the results are essentiallyidentical, the researchers
said.

Similarly, 21 percent of 12th graders in schools withtesting said they had used other illicit drugs like cocaineor
heroin in the last year, while 19 percent of theircounterparts in schools without screening said they haddone so.

The same pattern held for every other drug and grade level.Whether looking at marijuana or harder drugs like cocaineand
heroin, or middle school pupils compared with highschool students, the fact that their schools tested fordrugs showed
no signs of slowing their drug use.

While it is possible that schools that imposed screeninghad had even higher rates of use before, the researcherssaid
that was extremely unlikely because they controlledfor behavioral factors normally associated with substanceabuse
like truancy and parental absence.

"Obviously, the justices did not have the benefit of thisstudy," said Graham Boyd, a lawyer for the American CivilLiberties
Union who argued the case against drug testingbefore the Supreme Court last year. "Now there should be noreason for
a school to impose an intrusive or eveninsulting drug test when it's not going to do anythingabout student drug use."

But other researchers contend that the urinalysis conductedby schools is so faulty, the supervision so lax and theopportunities
for cheating so plentiful that the study mayprove only that schools do a poor job of testing.

"That's like blaming antibiotics if you didn't take themproperly, or blaming the doctor who prescribed them," saidDr.
Linn Goldberg, a professor of medicine at Oregon Healthand Science University, who conducted a much more limitedstudy
on two Oregon high schools last year. It found thatintensive, Olympic-grade testing could reduce drug use.

Still, Dr. Goldberg argued, even his study did not provethat testing limits consumption. "Schools should notimplement
a drug testing program until they're proven towork," he added. "They're too expensive. It's like havingexperimental
surgery that's never been shown to work."

Most schools have shied away from drug testing. TheMichigan study found that only 18 percent of the nation'sschools
did any kind of screening from 1998 to 2001, mostof them high schools. While a broad swath of the schoolpopulation
may be screened, from honor students inextracurricular activities to students on probation, mostof the testing focuses
on those who are suspected of usingdrugs.

Such tests do not violate the Fourth Amendment safeguardsagainst unreasonable searches and seizures, the SupremeCourt
has ruled, because children have limited expectationsof privacy, the tests are not overly intrusive and becausethey
are likely to deter substance abuse. Writing for thecourt in 1995, Justice Antonin Scalia described the"efficacy of
this means for addressing the problem" ofstudent drug use as "self-evident."

Seven years later, Justice Clarence Thomas restated thecourt's opinion, ruling that "the need to prevent and deterthe
substantial harm of childhood drug use provides thenecessary immediacy for a school testing policy."

Though the study may call those presumptions into question,it does not mean that drug testing is any lessconstitutional,
said the National School BoardsAssociation, which filed legal briefs in support of testingto the court. Given the
other constitutional grounds fortesting elaborated by the justices, particularly the roleof schools as guardians of
their students' well-being, theassociation maintains that schools should continue to test,if they so choose.

"I'm not saying school districts should ignore that study,"Naomi Gittins, an association lawyer, said. "I think it's
agood idea that schools take a look at that study. It's animportant decision that they're making."

The study would not have swayed Randall Aultman, formerprincipal of tiny Vernonia High School in Oregon whosedecision
to screen its athletes led to the Supreme Court's1995 ruling. Drug use was so rampant among his studentsthat he says
"we had to do something drastic," without evenknowing whether it was legal, much less effective.

"I don't think that drug testing works all the time, in allsituations," Mr. Aultman said. "And the truth is there
weremany kids who said, `Yeah, we quit while we were in seasonand once the season was over we went back to using drugs.'"

Even so, Mr. Aultman added, other students quit for life,and "at that time, it really worked." The Michigan study
was financed by grants from the NationalInstitute on Drug Abuse, part of the National Institutes ofHealth, as well
as the Robert Wood Johnson Foundation,which supports drug testing in schools. It collected dataon testing policies
at 722 middle and high schools, anddrew on anonymous surveys from 30,000 8th graders, 23,00010th graders and 23,000
12th graders, an enormousstatistical undertaking that may not be matched for years.The researchers assume that some
will lie about their druguse, but say that the effects are insignificant.

There is at least one important limitation of the Michiganstudy. It does not differentiate between schools that dointensive,
regular random screening and those that testonly occasionally. As a result, it does not rule out thepossibility that
the most vigilant schools do a better jobof curbing drug use.

"One could imagine situations where drug testing could beeffective, if you impose it in a sufficiently draconianmanner
- that is, testing most kids and doing itfrequently," Dr. Johnston, the Michigan researcher, said."We're not in a
position to say that wouldn't work."

The Supreme Court, however, has not ruled on whethertesting all students, even those not in extracurricularactivities,
is constitutional.

The National Institute on Drug Abuse said it would takeseveral more such studies before any certainty about theefficacy
of testing can be established. More research isbeing explored, it said, but the results are probably yearsaway.

Even so, some took the study as proof that education is themost effective weapon against substance abuse. They saidthat
while screening may give rise to a culture ofresistance, in which students take pride in beating thetest, the best
results come from convincing children thatmost children do not use drugs, making drugs lessappealing.

"At best, testing could be a band-aid, and certainly not ananswer," Tom Hedrick, director and founding member of
thePartnership for a Drug-Free America, said.

Jeffron BoynesResearch EditorUniversity of Illinois at Chicago(312) 413-8702; jboynes@uic.eduResearchers at the University of Illinois at Chicago's Jane AddamsCollege of Social Work will use a $1.9 million grant
to study theimpact of drugs and the justice system on women and their children.

The grant, from the National Institute on Drug Abuse, will support afive-year pilot project of research and teaching.

"Women who have families are being locked up or losing custody oftheir children, and the social costs have yet to
be calculated," saidLarry Bennett, the study's principal investigator. "We want to lookat the effects, not only of
drugs, but of the criminal justiceresponse to drugs, and what that means for children and families ofwomen."

Statistics show that:* Nearly 80 percent of female prisoners in the United States have ahistory of drug abuse*
Two-thirds of incarcerated women in the U.S. have dependent children* One in every 129 adult women is on probation or
parole(Source Greenfeld & Snell, 1999, "Women Offenders")During the project, UIC faculty will work with senior
substance-abuseresearchers. They envision building a substance-abuse researchprogram centered at the Jane Addams college.

Headed by Bennett, the researchers will conduct three pilot studiesto determine what will help women successfully
leave prison, avoidreturning to prison or drugs, and take care of their children oncethey're released.

The first study will investigate the impact of social services onsubstance-abusing mothers who have lost custody
of their children.The second study will examine the social service, employment, housingand drug treatment needs of
female ex-inmates in North Lawndale -- aneighborhood with a large number of female ex-offenders. The thirdstudy will
look at the influence of HIV on caregivers of childrenwhose mothers have a history of substance abuse and are currently
inthe criminal justice system.

Called the Jane Addams Substance Abuse Research Collaboration, theproject will build on the college's tradition of
academic andcommunity collaboration, says Bennett, a social work professor. It'sa joint effort involving the college
and researchers in other UICunits, including the School of Public Health and departments ofcriminal justice, psychiatry,
urban planning and publicadministration.

UIC will also work with Loyola University's criminal justicedepartment and with a number of social service agencies,
includingTASC (Treatment Alternatives for Safe Communities).

The grant will pay for a minority research fellowship, an advisoryboard of senior research associates, and for substance-abuse
researchseminars and conferences. UIC is one of six social work programsnationwide picked to receive the grant.

In addition to its substance-abuse research, the Jane Addams Collegeof Social Work serves as home to the Great Lakes
Addiction TechnologyTransfer Center; the Midwest AIDS Training and Education Center; theMidwest Latino Health, Research,
Training, and Policy Center; theKinship Care Practice Project; and the Jane Addams Center for SocialPolicy and Research.

NIH/National Institute on Drug AbuseStarting marijuana use during teens may result in cognitiveimpairment
later in lifeThere is evidence that individuals who start to smoke marijuana at anearly age--while the brain is still
developing--show greatercognitive deficits than do individuals who begin use of the drug whenthey are older, but the
reasons for this difference are unclear.

Scientists from the Harvard Medical School and from the intramuralresearch program of the National Institute on Drug
Abuse (NIDA) foundlasting cognitive deficits in those who started to smoke marijuanabefore age 17. The researchers
analyzed neuropsychological testresults from 122 long-term heavy users of marijuana and 87 subjectswho had used marijuana
only a few times (control subjects).Sixty-nine of the 122 users started using marijuana at age 17 orbefore. The subjects
were between the ages of 30 and 55 at the timeof the study, and all had refrained from any drug use 28 days priorto
testing.

Individuals who started using marijuana at age 17 or youngerperformed significantly worse on the tests assessing
verbal functionssuch as verbal IQ and memory of word lists than did those who startedusing marijuana later in life
or who had used the drug sparingly.There were virtually no differences in test results among theindividuals who started
marijuana use after age 17 and the controlsubjects.

The investigators suggest three possible hypotheses that mightexplain these differences. One possibility is that
early-onsetsmokers had lower innate cognitive skills before they ever startedsmoking marijuana. A second possibility
is poor learning of certaincognitive skills by young users of marijuana who neglect school andacademic pursuits. The
third and most ominous possibility is thatmarijuana itself has a neurotoxic effect on the developing brain.According
to the authors, further research will be required todetermine the relative contributions of these three factors.

WHAT IT MEANS: Youth who use marijuana before their midteens may showlong-term deficits in certain verbal skills--but
the reasons forthese deficits are not yet clear.

Dr. Harrison Pope and colleagues published the study in the March2003 issue of the journal Drug and Alcohol Dependence

Cannabis 'link to schizophrenia rise'Softer drugs law blamed for risk of mental illness as users aim to get heavily
'stoned'Jo Revill, health editor Sunday April 6, 2003 The Observer <http://www.observer.co.uk/politics/story/0,6903,930585,00.html>Stronger cannabis - and users getting stoned to a 'far more debilitating degree' - could lead to a rise in cases
of schizophrenia and present the NHS with a much larger bill, a leading drugs expert will warn tomorrow.

Professor John Henry believes that the Government, in its decision to relax the laws on cannabis, has overlooked
the burden that greater use puts on health services and on families - as well as the way young people are seeking to
heighten the effects of the drug.

Henry, a toxicologist and professor of accident and emergency medicine at Imperial College London, will talk about
the medical risks associated with the drug at a conference tomorrow. He fears that several hundred more young people
could end up in hospital suffering from schizophrenia, and might need anti-psychotic drugs to deal with their condition.

A year ago the Government announced plans to reduce the classification of cannabis from category B to C, after a
recommendation from the Police Federation that it was far less harmful than other drugs. The reclassification takes
place this summer, and anyone caught smoking a joint will be much less likely to be arrested or prosecuted for possession.

The policy change follows a controversial scheme in Lambeth, south London, in which the Metropolitan Police decided
to focus on hard drug users rather than cannabis smokers. The Met said it achieved great results against hard drug dealers,
but some health workers were worried that children in the area felt it was now legal - and safe - to smoke cannabis.

There is mounting concern among psychiatrists about the future impact of the softening of the law. Three million
people are thought to smoke cannabis regularly, a quarter of them young adults under the age of 29. It has been shown
that more people are growing cannabis for their own consumption.

Some doctors have argued that cannabis can be highly beneficial for patients suffering chronic pain, or those with
multiple sclerosis.

However, Henry will warn at the Royal Society of Medicine's conference that there has been a recent, dangerous shift
in the way people use cannabis and alcohol.

Recreational use has given way to a cultural acceptance of getting stoned regularly to a 'far more debilitating degree',
according to Henry. 'Modern cannabis is nearly 10 times the strength the "flower power" generation was used to, and
in Amsterdam it is at least twice as strong as in the UK,' he said. 'We know that for those who take the drug there is
a fourfold increase in schizophrenia and a fourfold increase in the chances of suffering major depressive illness.
Given that we know schizophrenia accounts for some 3 per cent of the total NHS bill, the costs could go up by another
1 per cent. That should be urgently considered by the Government.'

Henry believes there are emerging mental health problems associated with THC, or tetrahydrocannabinol, the main active
ingredient of cannabis, which in greater concentrations makes more potent forms of the drug, such as 'skunk'.

To investigate its effects on the brain, a study is about to begin at the Maudsley Hospital in south London. Volunteers
will be offered free cannabis, so that researchers can carry out brain scans and conduct memory tests to see how mental
activity is affected.

Professor Robin Murray, who is leading the study, said his view of the drug had changed in recent years. He used
to be sceptical when cannabis was blamed. 'Relatives would say "It seems to be the cannabis that makes my son or daughter
or brother psychotic" and I would say, "Oh, they're being hysterical, they're just trying to look for something to blame".
We've come to realise that it does have a significant effect, but it has taken us a long time to wake up to this.'

Others, however, point to the fact that rates of schizophrenia have not risen dramatically in the past 50 years to
correspond with increasing use of the drug. There is also a question over whether those who are likely to develop schizophrenia
are already predisposed to take cannabis.

Recent guidance on the provision of drugs for schizophrenia by the National Institute for Clinical Excellence (Nice)
estimated that treatment of schizophrenia in England and Wales was responsible for around 3 per cent of the entire
NHS budget - some £1 billion a year.

Cliff Prior, chief executive of Rethink, a charity helping those with mental illness, said: 'The public needs to
understand that this danger is real. There is growing evidence that cannabis may trigger schizophrenia in vulnerable
people.'

Study quantifies cost-benefit of family interventions to prevent teenalcohol useDesigned to prevent adolescent
alcohol use Iowa State Universityresearchers have calculated that brief family intervention programsdesigned to discourage
teen drinking are both beneficial andcost-effective. Their study found that each dollar spent onintervention programs
for adolescents was returned many times over insavings by preventing future costs associated with alcohol problemsin
adulthood.

The research, published in the Journal of Studies on Alcohol, wasfunded by NIDA and the National Institute of Mental
Health.

Acting NIDA Director Dr. Glen R. Hanson says, "This studydemonstrates that investing dollars in preventive interventionprograms
is not only a good public health practice, but it is a goodeconomic practice as well. The personal and public health benefits
ofpreventing teen drinking and adult alcohol abuse are well known. Lesswell known by the public are the costs of these
problems."

According to the latest statistics from the National Institute onAlcohol Abuse and Alcoholism, the annual economic
costs of alcoholabuse in 1998 were estimated to be $185 billion.

The Iowa investigators based their cost-benefit calculations on datafrom a longitudinal prevention trial with families
of sixth gradersfrom 33 rural schools in a Midwestern state. The families wererandomly assigned to one of two interventions
or to a control group.The two interventions were the Iowa Strengthening Families Program(ISFP), a seven-session intervention
with parents and studentstogether, and Preparing for the Drug Free Years (PDFY), afive-session intervention primarily
involving parents.

The researchers conservatively estimated that prevention of a singlecase of adult alcohol abuse produces an average
savings of $119,633in avoided costs to society. Factoring these savings into the costsand effectiveness of the two
interventions revealed that the ISFPintervention saved $9.60 in future costs for each dollar invested,and that the
PDFY intervention yielded a benefit-cost ratio of $5.85for each dollar invested.

The premise behind each intervention was similar: to focus onintervention during the critical period of transition
in earlyadolescence, to promote parent-child bonding, to encourage effectivefamily functioning, and to strengthen
the child's defenses againstnegative peer influences, such as increasing the skills in resistingpeer pressure to use
alcohol.

Analyses were based upon 478 families at the end of the four-yearstudy. One hundred sixty-two families were in the
ISFP group, 153 inthe PDFY group, and 163 in the control condition.

Between the critical ages of 13 and 16, fewer adolescents in the twotreatment groups started to use alcohol compared
to those in thecontrol group. Based on study analyses, it would then be expectedthat fewer of the teens in the two
intervention groups would beexpected to develop problems with alcohol use as adults.

Lead investigator Dr. Richard L. Spoth says, "Family skills-traininginterventions designed for general populations
have the potential todelay the onset of alcohol use, thereby avoiding the substantialcosts to society at a proportionally
small intervention cost."

Program Tries to Get Mentally Ill Off Streets Wed Aug 7,12:39 PM ETBy Alan Elsner, National CorrespondentNEW
YORK (Reuters) - They are a common sight on the streets of every Americancity -- unkempt men and women pushing supermarket
carts piled high withbelongings, muttering to themselves, pestering passersby for money andoccasionally making wild
gestures.

Studies estimate that up to 200,000 people suffering from severe mentalillnesses are homeless in the United States
at any given time. Tens ofthousands are military veterans.

Despite a substantial increase in programs designed to help in the past 10years, nothing seems to make a dent in
the numbers.

"We started doing outreach 10 or 15 years ago and we have learned that mostof these people don't want to be living
on the streets and are willing toaccept help and treatment if they are approached in the right way," saidDeborah Dennis,
project manager for the National Resource Center forHomelessness and Mental Illness.

After several years of stable figures, and even slight declines in someplaces, homelessness seems to be rising again,
possibly spurred by the tougheconomy.

According to the Coalition for the Homeless, the number of homeless singleadults in New York shelters has risen this
year to the highest levels since1990s. City outreach workers, community groups and city officials also reporta rise
in street homelessness, especially among the mentally ill.

The coalition said in April there were nearly 33,000 homeless adults andchildren sleeping each night in the municipal
shelter system -- the largestshelter population ever recorded in the city. The number jumped by more than5,500 during
2001, the largest single-year increase since the GreatDepression of the 1930s.

"We do know how to help and what works. The question is whether we arewilling to commit the resources necessary to
tackle the problem," Dennissaid.

Studies suggest men and women with illnesses like schizophrenia have at leasta 25 percent chance of becoming homeless.
Once they lose the ability to holddown a full-time job, a shortage of affordable housing soon pushes many ontothe
streets. And since a high proportion are also abusing drugs and alcohol,it is not easy to lure them into programs.

Alan Felix, a New York psychiatrist who has been working with the homelessfor longer than 15 years, has developed
a program called Critical TimeIntervention (CTI) that has shown promising results in helping such people.

Under the program each client is assigned a personal case manager for acritical nine-month period, during which they
move from the shelter back intothe community into some form of subsidized group housing.

SHELTER WAS IN HOLLYWOOD MOVIE

A follow-up study found that people who went through the CTI program spentonly a third as many nights on the streets
during the next nine months as acontrol group of homeless people who had not been offered special services.Similar
programs are now being launched in other cities including LosAngeles, Philadelphia, San Francisco and San Diego, as well
as among militaryveterans nationwide.

"Trying to make the transition from the shelter to the community on their ownis too much for most people with severe
mental illness. The case managerhelps them get over this hurdle," said Felix, who works out of the FortWashington
shelter, a disused National Guard armory which was featured in a1993 Hollywood film starring Matt Dillon and Danny Glover,
"The Saint of FortWashington.

At that time, up to a thousand homeless men slept side by side in the shelterin a huge room, their beds lined up
in neat rows. Now, the shelterspecializes in the mentally ill and houses only around 200 people. The vasthall has
been turned into a state-of-the-art indoors athletics track.

The case managers working with Felix try to ensure that their clients remainon medication and off drugs, help them
manage their money, solve crises thatmay occur, try to put them back in touch with their families and teach themnecessary
life skills.

"We've had people who didn't know how to open the windows in their housing orhow to use a microwave oven, simple
things like that which the rest of ustake for granted," said Felix.

The problem with such programs is that they are labor intensive and can onlyhandle a relatively small number of people
at any one time.

Nationally, a 1996 study found that an estimated 842,000 people were homelessin any given week and that 3.5 million
adults and children experienced someperiod of homelessness over the course of a year.

When they are not on the streets, large numbers of mentally sick people windup in jail.

"Jails and prisons have become the final destination of the mentally ill inAmerica. It's a huge problem. There are
more mentally ill folk in stateprisons than in state hospitals," said University of Rochester psychiatristSteve Lamberti,
who runs another program for the severely mentally ill.

"The Los Angeles County Jail has become the nation's largest mentalinstitution," he said.

University of Pennsylvania researcher Dennis Culhane believes interventionprograms to get the mentally ill off the
streets are highly cost effective.

His research in New York found that the cost of providing shelter, jail andhospital services for them came to an
average of $40,499 per person.Residents used $16,282 less in services after moving into supervised housing,with the
biggest drops in shelter use and jail time, which fell by 85percent.

"A considerable amount of public dollars is spent essentially maintainingpeople in a state of homelessness," Culhane
said in a 2001 interview. "Byputting those same dollars into supportive housing, the solution can pay foritself."

SOURCE: LifeSkills TrainingStudy Finds That Three Most Popular Teen Drug Prevention ProgramsHave No Long-Term
EffectThe Good News Is That Parents Need Not DespairNEW YORK, NY--(INTERNET WIRE)--Aug 13, 2002 -- The news isdevastating
for parents who were hoping to pre-empt their kids' useof drugs with school or community-based prevention programs. But
thefindings could be a blessing in disguise for communities that arecommitted to keeping their kids safe from drugs
and other riskybehaviors.

The Associated Press reported on August 3rd that the three best knowndrug prevention programs for kids are "either
ineffective or haven'tbeen sufficiently tested," and that despite "a decade of efforts fromthe federal government
to promote proven programs, many schools stilluse heavily marketed curricula that have not been evaluated, havebeen
evaluated inadequately or have been shown to be ineffective inreducing substance abuse."

The study's author also found that unbelievably, only 19 percent ofschools reported using research-based programs,
commenting, "It's nota good use of taxpayers' money."

"This is actually good news for parents, because it finally brings tolight the real reason that many well-intentioned
prevention effortshave failed," comments Gilbert J. Botvin, Ph.D. Professor of PublicHealth and Psychiatry at Weill
Medical College of Cornell University,and President, Society for Prevention Research.

Botvin points to the dramatic advances in prevention research,leading to the development of proven prevention programs
that armkids with the solid social skills, drug refusal skills, andself-management skills needed to fend off the pressures
and socialinfluences to smoke, drink, or use illicit drugs.

Thanks to advances in prevention science, we now have the toolsavailable to keep our kids safe. Studies published
in top scientificjournals show that the most powerful of these programs can cuttobacco, alcohol, and illicit drug
use by up to 60%. "Now that weknow exactly what works and what doesn't work, the challenge is tohelp parents, educators
and communities to find programs that areproven to work and promote their widespread use," adds Dr. Botvin."

To identify a proven anti-drug program for your school, church, orcommunity, check out the list of U.S. federal agencies
below.

Background on Dr. Gilbert J. Botvin and LifeSkills Training

Dr. Gilbert J. Botvin is founder of LifeSkills Training, widelyregarded as the most effective and rigorously tested
school-basedprevention program. The training works because it equips kids withthe self-management tools they need
to effectively resist outsideinfluences as early as middle school and even upper elementary age.

Proven to cut alcohol, tobacco and drug use by up to 87 percent,LifeSkills Training is based on 20 years of research
by Dr. Botvinand his associates at the Institute for Prevention Research ofCornell University Medical College. More
than a dozen publishedresearch studies have documented the effectiveness of the LSTapproach.

LifeSkills Training is the only substance abuse prevention programrecommended by every key federal agency concerned
with substanceabuse, including the National Institute on Drug Abuse, the Centersfor Disease Control and Prevention,
the Center for Substance AbusePrevention, the U.S. Department of Education, the U.S. Department ofJustice, and the
White House Office of National Drug Control Policy.The program is currently in use in 7,500 classrooms and 3,000schools/districts
throughout all 50 states, serving more than 1million students, and worldwide in Japan, Korea, Mexico, Sweden, HongKong,
New Zealand and Argentina.

Federal Agencies' Lists of Effective Programs

The major federal agencies involved with substance use have all maderecommendations to the field about programs that
have been repeatedlyproven to work so they can be more thoroughly disseminated. Theseagencies include:

- National Institute on Drug Abuse (NIDA): "Preventing Drug Use AmongChildren and Adolescents: A Research-Based Guide"
enumerates some ofthe most outstanding and rigorously tested prevention programs andprovides a resource for those
making choices about prevention needs.Go to: 165.112.78.65/pubs/preventpubs.taf?functions=form

Effectiveness of Integrated Services for Homeless Adults with SeriousMental Illness [.pdf]http://www.dmh.cahwnet.gov/WhatsNew/docs/AB2034-4-23.pdfAvailable to the Internet community from the California Department ofMental Health, this 55-page report to the Legislature
provides recentinformation on the Department of Mental Health's administration andimplementation of programs at county
and city levels that servehomeless adults with serious mental illness in the state ofCalifornia. Some of the report's
findings include a 66% decrease inhospitalization, a 82% decrease in the number of days incarcerated, a79% decrease
in the number of days spent homeless, and a 169%increase in the number of days employed for the 305 Los AngelesCounty
participants. Available in Adobe Acrobat (.pdf) format, thisreport contains small fonts and maybe more easily readable
whenprinted. [MG]From The Scout Report, Copyright Internet Scout Project 1994-2002.http://scout.cs.wisc.edu/

Report: Millions Behind Bars in U.S.By JONATHAN D. SALANT Associated Press WriterAugust 25, 2002 WASHINGTON
(AP) – One in every 32 adults in the United States was behind bars or on probation or parole by the end of last year,
according to a government report Sunday that found a record 6.6 million people in the nation's correctional system.The
number of adults under supervision by the criminal justice system rose by 147,700, or 2.3 percent, between 2000 and 2001,
the Justice Department reported. In 1990, almost 4.4 million adults were incarcerated or being supervised."The overall
figures suggest that we've come to rely on the criminal justice system as a way of responding to social problems in a way
that's unprecedented," said Marc Mauer, assistant director of the Sentencing Project, an advocacy and research group that
favors alternatives to incarceration. "We're setting a new record every day."Almost 4 million people were on probation,
2.8 percent more than in 2000, while the number of people in prison grew by 1.1 percent to 1.3 million, the smallest annual
increase in nearly three decades. More than half of those on probation – 53 percent – had been convicted of felonies,
according to the Bureau of Justice Statistics report.Experts noted the recent trend of arrests declined for murder, rape
and other violent crimes. Many of those on probation were convicted of using illegal drugs or driving while intoxicated, the
report showed.In addition, some states have eliminated mandatory minimum sentences for certain crimes. California's Proposition
36, passed in 2000 with 61 percent of the vote, requires treatment rather than incarceration for nonviolent drug offenders.
Most of those drug users wind up on probation."The collection of reforms, from drug courts to treatment in lieu of incarceration
to sentence reforms like getting rid of mandatory minimums and expanding community correction options, have the effect of
redirecting people from prison to probation," said Nick Turner, director of national programs for the Vera Institute of Justice.
The nonprofit research group works with governments on criminal justice issues.The government report found that 46 percent
of those discharged from parole in 2001 had met the conditions of supervision, while 40 percent went back to jail or prison
for violations.Texas had more adults under correctional supervision than any other state, 755,100. California was second
with 704,900. Texas also had the most adults on probation, 443,684, followed by California at 350,768.Whites accounted
for 55 percent of those on probation, while blacks made up 31 percent, statistics show.

Report: Millions Behind Bars in U.S.By JONATHAN D. SALANT Associated Press WriterAugust 25, 2002 WASHINGTON
(AP) – One in every 32 adults in the United States was behind bars or on probation or parole by the end of last year,
according to a government report Sunday that found a record 6.6 million people in the nation's correctional system.The
number of adults under supervision by the criminal justice system rose by 147,700, or 2.3 percent, between 2000 and 2001,
the Justice Department reported. In 1990, almost 4.4 million adults were incarcerated or being supervised."The overall
figures suggest that we've come to rely on the criminal justice system as a way of responding to social problems in a way
that's unprecedented," said Marc Mauer, assistant director of the Sentencing Project, an advocacy and research group that
favors alternatives to incarceration. "We're setting a new record every day."Almost 4 million people were on probation,
2.8 percent more than in 2000, while the number of people in prison grew by 1.1 percent to 1.3 million, the smallest annual
increase in nearly three decades. More than half of those on probation – 53 percent – had been convicted of felonies,
according to the Bureau of Justice Statistics report.Experts noted the recent trend of arrests declined for murder, rape
and other violent crimes. Many of those on probation were convicted of using illegal drugs or driving while intoxicated, the
report showed.In addition, some states have eliminated mandatory minimum sentences for certain crimes. California's Proposition
36, passed in 2000 with 61 percent of the vote, requires treatment rather than incarceration for nonviolent drug offenders.
Most of those drug users wind up on probation."The collection of reforms, from drug courts to treatment in lieu of incarceration
to sentence reforms like getting rid of mandatory minimums and expanding community correction options, have the effect of
redirecting people from prison to probation," said Nick Turner, director of national programs for the Vera Institute of Justice.
The nonprofit research group works with governments on criminal justice issues.The government report found that 46 percent
of those discharged from parole in 2001 had met the conditions of supervision, while 40 percent went back to jail or prison
for violations.Texas had more adults under correctional supervision than any other state, 755,100. California was second
with 704,900. Texas also had the most adults on probation, 443,684, followed by California at 350,768.Whites accounted
for 55 percent of those on probation, while blacks made up 31 percent, statistics show. On the other hand, 46 percent of those
incarcerated were black and 36 percent were white.

Smoking pot alters more than mood --human immune system affected,USF/UCLA study findsTampa, FL (Aug. 27, 2002)
- Marijuana may alter immune function inpeople - but the jury is still out on whether it hurts or helps thebody's
ability to fight infection or other diseases, reportresearchers at the University of South Florida College of Medicineand
the UCLA School of Medicine in Los Angeles.

"The bottom line is you cannot routinely smoke marijuana without itaffecting your immune system," said Thomas Klein,
PhD, professor ofmedical microbiology and immunology at USF. "However, because of thecomplexity of the immune system,
we can't say yet whether the effectwe've observed in humans is good or bad."

A study by USF and UCLA is the first to show that healthy humans whosmoke marijuana appear to alter the expression
of marijuanareceptors, or molecules, on immune cells in their blood. The findingswere reported in the June issue of
the Journal of Neuroimmunology.

Pot's influence on the immune system continues to be hotly debated.While more human studies are needed, overwhelming
evidence fromanimal studies indicates that marijuana and its psychoactivecompounds, known as cannabinoids, suppress
immune function andinflammation.

"This suggests marijuana or cannabinoids might benefit someone withchronic inflammatory disease, but not someone
who has a chronicinfectious disease such as HIV infection," said Dr. Klein, leadinvestigator of the study.

The USF/UCLA group is one of few in the world conducting studies todefine the role of cannabinoid receptors in regulating
immunity inboth drug abusers and nonusers.

If the results in animals hold true in humans, their work might leadto the development of safe and effective cannabinoid
drugs forcertain diseases, Dr. Klein said. "If the cannabinoids in marijuanaare effective immune suppressors, this
property might be harnessed totreat patients with overly aggressive immune responses orinflammatory diseases like
multiple sclerosis and rheumatoidarthritis."

Receptors that react to delta-9 tetrahydrocannabinol or THC, thecompound in marijuana that produces a high, have
been found intissues throughout the body and in the brain. A naturally circulatingTHC-like substance called anandamide
also binds to and activatesthese marijuana, or cannabinoid, receptors, indicating that thebody's own cannabinoid system
plays a physiological role in normalimmunity as well as defining moods, Dr. Klein said.

In the USF/UCLA study, researchers analyzed blood samples from 56healthy volunteers - including 10 chronic marijuana
smokers, ages 22to 46, participating in lung and immune function studies at UCLA. Themarijuana smokers denied use
of any other drugs, and the nonsmokersdenied all illegal drug use.

Because no accurate way yet exists to directly study the expressionof cannabinoid receptors on immune cells, the
researchers looked atthe genetic material (messenger RNA) that is the direct predecessor,or precursor, of the receptor.

They found that the baseline genetic expression of this precursor RNAwas consistent across all age, gender and ethnic
groups. But, theperipheral blood cells from the marijuana users expressedsignificantly higher levels of cannabinoid
receptor messenger RNAthan blood cells from non-users. The levels increased regardless ofthe amount of marijuana use,
although all users in the study had ahistory of smoking pot several times or more a week.

Ill Americans Seek Marijuana's Relief in CanadaSeptember 8, 2002 By CLIFFORD KRAUSS - - NY TimesVANCOUVER,
British Columbia - Four decades ago, a wave of Americandraft dodgers fled to Canada rather than fight in Vietnam. Someturned
to planting marijuana seeds to make a living and spurred anunderground industry that is now booming across British Columbia.

Over the last year or so, a new generation of Americans has flockedinto western Canada, fleeing the Bush administration's
crackdown onthe clubs that say they provide marijuana to sick people,particularly in California.

A handful who face drug charges and convictions in the United Stateshave applied for political asylum. Hundreds more
American marijuanasmokers live underground existences here, local marijuana advocatessay.

Canada is in the awkward position in which it either must stand up tothe United States - and encourage more refugees
and asylumapplications - or evict people who say they suffer from cancer andother deadly diseases.

While general use of marijuana is illegal in both countries, Canadahas been far more tolerant of its use for medical
purposes.

"It's an exodus," said Renee Boje, 32, a California fugitive fromdrug charges who has applied for refugee status.
"Canada has ahistory of protecting the American people from its own governmentlike during the Vietnam War, and the
Underground Railroad thatprotected American runaway slaves."

Most of the Americans here do not face charges at home, marijuanaadvocates say, but came because they can get the
drug more cheaplyand easily here now since the American clubs were shut down."Compassion clubs" thrive in several
Canadian communities to servewhat they say are the medical needs of severe pain sufferers.

"In the last year the number of Americans coming and intending tostay has skyrocketed," said Marc Emery, president
of the B. C.Marijuana Party, who provides legal aid to the Americans. Heestimated that the number of recent arrivals
was "in the hundreds."

Some of them work on farms, living a countercultural life not verydifferent from that of the previous generation
of American refugees.Others are living on the street, or moving from couch to couch inhomes of Canadian marijuana
users. Some have gone into businesseslike herbal medicine stores or work in marijuana cultivation.

To Bush administration officials, the American fugitives are simplylawbreakers.

"It's regrettable that people who are charged with criminal offensesin the United States don't face justice here
and put a burden onanother country," said John Walters, President Bush's drug policychief.

He said that there was no evidence that smoking marijuana was aneffective medicine, and that the agenda of many who
argue formedicinal marijuana is to legalize drugs.

Attorney General John Ashcroft and the Drug EnforcementAdministration director, Asa Hutchinson, have stiffened enforcementagainst
marijuana clubs that had grown around California after aninitiative called Proposition 215 passed in 1996, making marijuanalegal
for treating some sick people. Asserting the superiority offederal antidrug laws, federal agencies have raided some clubs,
andothers have closed or gone underground.

Steven W. Tuck, a 35-year-old disabled veteran of the Army, fled toCanada pretending he was going fishing after his
club was repeatedlyraided and he faced drug charges. He was arrested for overstaying hisvisa and, fearing deportation,
applied for refugee status.

Sitting recently in Vancouver's Amsterdam Cafe, where smokingmarijuana is allowed, he was sweating and shaking awaiting
a friendwho had gone out to buy some. "I have to have marijuana to stayalive," said Mr. Tuck, who said his torment
began in 1987 with anArmy parachuting accident that caused spinal and brain injuries.

If he is sent home and denied marijuana, Mr. Tuck says, he fears hewill die "choking on my vomit in jail."

The Canadian Justice Ministry will not discuss refugee cases. Togrant asylum, Canada would have to determine that
the Americans wouldface unwarranted persecution at home.

The cases come at a time when the cabinet and Parliament arediscussing whether to decriminalize marijuana, with many
Canadiansarguing that American attitudes are overly restrictive. [On Sept. 4,a Canadian Senate committee recommended
that the country legalizemarijuana use for people over 16.

There is also a cabinet debate over whether the government shouldprovide marijuana to chronically ill Canadians or
conduct clinicaltrials first.

"We can't base our policy on social issues like this on Americanstandards, especially in an area where they're very
conservative,"said Industry Minister Allan Rock, a former health minister whobelieves that chronically ill patients
should have access toquality-controlled marijuana.

The most prominent American fugitive here is Steve Kubby, 55, theLibertarian Party candidate for governor of California
in 1998. Heand his wife, Michele, have an Internet news program on marijuanaissues.

They fled California last year for the rural British Columbia town ofSechelt after the police found 265 marijuana
plants, a mushroom stemand some peyote buttons in their house. Mr. Kubby had been sentencedto four months of house
arrest and three months of probation, whichhe feared might eventually lead to a prison term in which he would bedenied
the marijuana that he says he needs to treat his adrenalcancer.

"If I don't smoke pot," he said, "my blood pressure goes through theroof and would either burst a blood vessel or
cause a heart attack."

He appealed his sentence, then brought his family to Canada. He wasarrested here, and he could be deported.

Meanwhile, he applied for permission to cultivate and possessmarijuana for his own medical use. He provided Canadian
authoritieswith a letter from a University of British Columbia doctor whosubstantiated his need "to continue to use
cannabis to control thesymptoms caused by his disease."

The government recently granted him the right to grow and possess alimited amount for a year, which advocates viewed
as a major victory.

"It's threatening to the whole ideology of prohibition," Mr. Kubbysaid, "which says any marijuana use is criminal."

More Americans used illegal drugs in 2001, U.S. study says Fri Sep 6,8:55 AM ETSvetlana Kolchik USA TODAYNearly
2 million more Americans used illicit drugs in 2001 than in2000, according to a major government survey released Thursday.

Experts say reasons range from stress after Sept. 11 to the shakyeconomy to an atmosphere more accepting of marijuana
use.

In 2001, an estimated 7.1% of the U.S. population, or 15.9 millionpeople, identified themselves as current drug users.
In 2000 and1999, about 6.3%, or 14 million, said they were drug users.

The National Household Survey on Drug Abuse, a survey of 70,000people conducted by the Department of Health and Human
Services isthe largest study of drug use in America. Other findings:* The percentage of Americans age 12 and older
who consume alcoholoccasionally (at least one drink in the past month) rose from 46.6%in 2000 to 48.3% in 2001.

* The rates of drug use among younger people rose significantly. In2000, 9.7% of teenagers and 15.9% of young adults
18-25 said theyused a drug in the month before the survey, vs. 10.8% of teens and18.8% of young adults in 2001.

* Marijuana, Ecstasy, pain relievers, tranquilizers and othernon-prescribed psychotherapeutic drugs remain the most
popular. Asmany as 2.4 million Americans used marijuana for the first time in2000, 1 million more than in 1990, the
survey estimated.

John Walters, director of the White House Office of National DrugControl Policy and an opponent of relaxing drug
laws, says thegrowing social acceptance of marijuana may have contributed to itspopularity. Proposals to decriminalize
marijuana possession send thewrong message, he says.

''The 'forbidden fruit' phenomenon is a very strong motivator,'' saysMitchell Earlywine, who teaches about drugs
at the University ofSouthern California.

Glen Hanson, director of the National Institute on Drug Abuse, citespost-Sept. 11 stress and concern over the economy
as factors. ''Weare under a lot of stress in this country now,'' he says. ''Drugsstimulate the pleasure center,''
and people may be using drugs tocope with problems.

About 16.6 million Americans are dependent on drugs or alcohol, thesurvey says; 2.4 million are dependent on both.

UF study: Marriage can reduce life of crimeGAINESVILLE, Fla. --- The bliss of a steady marriage is a strongantidote
to a life of crime, a new University of Florida study finds.In a study of paroled men, the UF research team found that
the mosthardened ex-cons were far less likely to return to their crooked waysif they settled down into the routines
of a solid marriage, said AlexPiquero, a UF professor of criminology and law who led the study.

This tendency to stay on the straight and narrow was common amongwhites, blacks and Hispanics, according to the study
published in theSeptember issue of the journal Social Science Quarterly.

"People who are married often have schedules where they work 9-to-5jobs, come home for dinner, take care of children
if they have them,watch television, go to bed and repeat that cycle over and overagain," Piquero said. "People who
are not married have a lot of freerein to do a lot of what they want, especially if they are notemployed."

There is a twist. Common-law marriages or living with a partner didnot have the same crime-reducing effect as did
traditional marriagesin which the knot is tied, the union is registered at the courthouse,and there is a general expectation
to lead a steady life.

In fact, the study found that cohabiting without marriage actuallyincreased the likelihood that parolees would recommit
crimes, atleast among parolees who are not Caucasian.

"Nonwhites, especially African-Americans, have lower rates ofmarriages than whites, and it could be, especially among
malecriminal offenders, that the idea of marriage is a foreign concept tothem, perhaps because they may have come
from single-parent familiesor are surrounded by single-parent households," he said.

Statistics indicate many nonwhite parolees are not steadily employed,so women may not look upon them as desirable
marriage partnersanyway, Piquero said. Rather than entering relationships withpartners who might stymie their involvement
in crime, ex-cons end upsticking with women who allow them to continue their errant ways, hesaid.

"There's something about crossing the line of getting married thathelps these men stay away from crime," he said.
"If they don't crossthat line, they can continue their lifestyles, which are prettyerratic."

Using arrest records from the state of California, Piquero, KarenParker, also a UF criminology and law professor,
and John MacDonald,a University of South Carolina criminal justice professor, trackedeach of 524 men in their late
teens and early 20s for a seven-yearperiod after they were paroled from the California Youth Authorityduring the 1970s
and 1980s. The sample of men, who had beenincarcerated for lengthy periods of time, was 48.5 percent white, 33percent
black, 16.6 percent Hispanic and 1.9 percent other races. Thestudy, funded by the National Institute of Justice, sought
toidentify factors leading to continued involvement in crime, as wellas those relating to crime reduction, Piquero
said. It examinedalcohol and drug use, marriage and employment.

The only other factor to influence recidivism was heroin dependency,Piquero said. Parolees who abused heroin became
involved in a widerange of violent and nonviolent crimes, he said.

Piquero said he was surprised by the results.

As the state's last stop for criminal offenders, the California YouthAuthority draws the worst criminal offenders.
"These aren't one-timeoffenders who are selling a few joints out on the street," he said."I honestly didn't expect
to find the 'marriage effect' among thesepeople, because they had made lots of bad choices in their livesprior to
this point and had long, long rap sheets," he said.

The results also may apply to criminals across the country becauseresearch has shown many crime-related factors are
similar nationallyand even internationally, Piquero said. "Serious offenders inCalifornia are not that much different
from serious offenders inFlorida, New Jersey or New York," he said.

The findings underscore the importance of life circumstances overtime, Piquero said. "It shows that life events such
as marriagematter and can trigger changes from one pathway to another, causing amove in a different direction," he
said.

Recreational use of the drug 'Ecstasy' causes new kind of brain damageResearchers at Johns Hopkins have found
that doses of the popularrecreational drug "Ecstasy" similar to those that young adultstypically take during all-night
dance parties cause extensive damageto brain dopamine neurons in nonhuman primates. Brain dopamine cellshelp control
movement, emotional and cognitive responses, and theability to feel pleasure, according to the study, published in theSeptember
27 issue of Science. The findings may also shed light onthe mechanisms by which Ecstasy damages brain cells.

"The most troubling implication of our findings is that young adultsusing Ecstasy may be increasing their risk for
developingparkinsonism, a condition similar to Parkinson's disease, as they getolder," said George A. Ricaurte, M.D.,
associate professor ofneurology at The Johns Hopkins University School of Medicine and leadauthor of the study.

Parkinsonism occurs when brain dopamine neurons are damaged beyond acertain threshold, resulting in a 90 percent
or greater loss of braindopamine, Ricaurte explained. The new findings raise concern that ifEcstasy damages brain
dopamine neurons in humans, as it does inmonkeys, parkinsonism could develop years after taking the drugbecause brain
dopamine declines with advancing age, said Ricaurte.

"The lack of obvious immediate harmful effects of Ecstasy is partlyresponsible for the widely held belief that the
drug is safe," saidRicaurte. "But people should be aware that the use of Ecstasy indoses similar to those used in
recreational settings can damage braincells, and this damage can have serious effects."

Ricaurte added that the patterns of Ecstasy use have changed sincethe 1980s when the drug was taken primarily on
college campuses, andindividuals typically took one or two doses twice monthly. Morerecently, many individuals take
several sequential doses of the drugover the course of a single night. The new study was part of ongoingefforts to
further evaluate the neurotoxic risks posed by Ecstasy tohumans, said Ricaurte.

To measure the adverse effects of Ecstasy, also known as MDMA or3,4-methylene-dioxymethamphetamine, the researchers
gave squirrelmonkeys three sequential doses of Ecstasy at three-hour intervals.Following this regimen, which is similar
to that used by recreationalEcstasy users at all-night parties, they found that in addition toserotonin deficits,
which the drug has been known to cause for sometime, the monkeys unexpectedly developed severe, long-lasting braindopamine
deficits.

Then, using a variety of techniques to look at a region of the braincalled the striatum, they found that 60 percent
to 80 percent of thedopaminergic nerve endings were destroyed. To determine if theseresults were unique to squirrel
monkeys, the researchers performedthe experiments again, this time with baboons, and obtained similarfindings of neuronal
injury.

"We do not yet know if our findings in nonhuman primates willgeneralize to human beings but, needless to say, this
is a majorconcern," said Ricaurte.

"The message seems clear," added Ricaurte. "The neurotoxic potentialof MDMA is high, and use of several sequential
recreational dosescould have serious, long-term consequences."

Glen R. Hanson, Ph.D., D.D.S., acting director of the NationalInstitute on Drug Abuse, adds, "This study underscores
the need formore research about the extent and nature of the damage that Ecstasymay cause. Clearly, the implications
of these findings are cause forconcern and should serve as a warning to those thinking about usingEcstasy."

Parents' risky behavior rubs off on childrenParents who smoke and drink and generally do not take care of theirhealth
may influence their children to do the same, according to anew study that links parents' risky behavior to early sexual
activityin teens.

Adolescents of parents who smoked were around 50 percent more likelyto have had sex. They were also more likely to
have had sex by age15, Wilder and Watt report in the September issue of the MilbankQuarterly.

Teens with parents who drink heavily tend to drink as well, and teenalcohol use is closely linked to the early onset
of sexual activity,they explain. For boys, but not girls, parents' failure to wearseatbelts is associated with a modest
increased likelihood ofadolescent sex.

"Because parents serve as important role models for their children,it stands to reason that parents who exhibit unsafe
behaviors areespecially likely to have children with similar tendencies," theresearchers say.

In contrast, high levels of supervision by parents resulted in areduced likelihood of sexual activity in some children.
Boys whosefathers are present at key times of the day--when the leave andreturn from school and bed time--are less
likely to be sexuallyactive, as are girls whose mothers are present at those times.However, mothers' presence has
no impact on boys' likelihood of beingsexually active and fathers' presence has no impact on girls.

The researchers used data collected for the National LongitudinalStudy of Adolescent Health, which includes information
on sexualbehavior for approximately 19,000 adolescents in grades 7 through 12.The data set also provides information
on risky health behaviors,such as smoking, drinking heavily and not using a seatbelt, for oneparent in each teen's
household.

Among the respondents, 37 percent of girls and 39 percent of boysreported having had sex. Nearly two-thirds of these
adolescents useda contraceptive, most often a condom, at first intercourse.

According to Wilder and Watt, however, unsafe parental behavior hadlittle or no effect on whether the sexually active
teen usescontraceptives during his or her sexual encounter.

The researchers found little to explain why some teenagers usecontraceptives and others do not, although the study
did show thatone of the strongest predictors was the year in which the adolescentfirst had sex. Teenagers who first
had sex in 1991 or later were morelikely to use contraceptives, likely reflecting the greater awarenessof sexually
transmitted diseases inspired, in part, by the AIDSactivism movement.

Teenagers whose parents engage in risky health behaviors are alsomore likely to engage in other risky behaviors,
such as smoking,drinking, associating with peers who use drugs and other delinquentbehavior such as stealing and damaging
property, the study shows.

"Given the importance of parental risk in explaining both earlysexual activity and a host of problem behaviors linked
tocontraceptive nonuse," the researchers say, "public health campaignsthat urge parents to act responsibly by engaging
in health-consciousbehaviors are likely to help reduce precocious and unsafe sexualactivity among teens."

NATIONAL STUDY YIELDS NEW DATA ON MISSING, RUNAWAY CHILDRENIn the wake of a summer when tragic stories of abducted
and murderedchildren seemed to be making headlines daily, the results of a newlyreleased national survey of missing
children present important newinformation on how many children actually become missing--and why.

The findings of the Second National Incidence Studies of Missing,Abducted, Runaway and Thrownaway Children (NISMART-2)
are beingdistributed in a series of Office of Juvenile Justice and DelinquencyPrevention (OJJDP) bulletins and reports.

The first four bulletins were released at the White House Conferenceon Missing, Exploited, and Runaway Children on
Wednesday, Oct. 2, inWashington, DC, and are available to the public online athttp://www.ojjdp.ncjrs.org.

NISMART-2 is based on a survey of over 16,000 households conducted bythe Institute for Survey Research (ISR) at Temple
University plusstudies of law enforcement agencies and juvenile facilities conductedby Westat, Inc. According to the
NISMART-2 findings, there were anestimated 1,315,600 children who were missing from their caretakersin 1999, and an
estimated 797,500 of these children, or 61 percent,were reported to authorities as missing.

"Media reports of a missing child conjure up frightening and tragicimages, but the problem of missing children is
far more complex thanthe headlines suggest," says Heather Hammer, senior study director atTemple's ISR and principal
investigator for NISMART-2.

To provide an accurate estimate of the incidence of missing childrenin the U.S., and an assessment of the circumstances
under whichchildren go missing, investigators identified five categories ofmissing child episodes:

"It's important to understand that while notorious kidnappings suchas Samantha Runnion, Elizabeth Smart and Danielle
Van Dam makeheadlines, they actually represent a fraction of all missing childrenabducted by a nonfamily perpetrator,"
Hammer said. And there is noindication that they are increasing in frequency, although we have noinformation about
abductions during the course of 2002, she added.

There were an estimated 58,200 children who were victims of nonfamilyabduction in the study year. Of the 115 children
who were victims ofa stereotypical kidnapping by a stranger involving elements ofheinous crime--a child being abducted
overnight, taken longdistances, held for ransom, or killed, 40 percent were killed, andanother four percent were not
recovered.

Other incidents classified as nonfamily abductions include any childmoved or detained by a nonfamily perpetrator
for a substantial periodof time by physical force or threat, or a child who is abducted andsexually assaulted by a
nonfamily perpetrator and released. Among theexamples of nonfamily abductions yielded by the National HouseholdSurvey
of Primary Caretakers conducted by the ISR were a babysitterwho refused to let three children go home until she was paid;
a15-year-old girl pushed into a boys' bathroom at school and sexuallyassaulted by several older boys; a four-year-old
taken on a 20-milejoy ride by a school bus driver.

While parents of younger children are particularly anxious about thedanger of kidnapping, NISMART-2 revealed that
teenagers were the mostfrequent victims of both nonfamily abductions and stereotypicalkidnappings. Eighty-one percent
of all nonfamily abducted childrenwere age 12 or older. Girls were the predominant victims, reflectingthe frequency
of sexual assault as a motive for many nonfamilyabductions, the researchers noted. Nearly half of all nonfamilyabduction
victims and stereotypical kidnapping victims were sexuallyassaulted.

An estimated 203,900 children were victims of a family abduction (thetaking or keeping of a child in violation of
a custody agreementinvolving some element of concealment, flight, or intent to altercustodial rights permanently),
and in more than three-quarters ofthese cases, the perpetrator was a parent: 53 percent were abductedby their biological
father, 25 percent by their biological mother.

"These children actually reflect a much larger problem," Hammerpointed out. "A child can be unlawfully removed from
custody by afamily member and yet the child's whereabouts are fully known. Achild abducted by a noncustodial parent
and taken to that parent'shome out of state has been abducted but is not necessarily missing."Family abducted children
accounted for only 9 percent of all missingchildren and 7 percent of those reported missing in the study year.

In family abductions, younger children appear to be more vulnerable.Teenagers, who have relatively more independence
and control overwhere they go and stay, accounted for a relatively small proportionof family abduction victims.

Runaways/Thrownaways

In 1999, there were an estimated 1,682,900 runaway/thrownaway youth,37 percent of whom were missing. Runaway/thrownaway
youth includechildren who leave home without permission and stay away overnight;children who are away from home and
choose not to return and stayaway either one or two nights, depending on their age, and childrenwho are asked or told
to leave home by a parent or other adult, orprevented from returning home when adequate alternative care has notbeen
arranged. Runaways/thrownaways accounted for 48 percent of allmissing children and 45 percent of those reported missing
in thestudy year.

"These numbers, too, represent a complex set of problems. Childrenwho leave home do so for a variety of reasons.
More than one-quarterof these were children either using hard drugs or substancedependent. One in five had been physically
or sexually abused at homeor afraid of abuse upon return," Hammer stated.

Although the stereotype of the runaway is a youth roaming andsleeping on the streets of a big city, prey to drugs
and violence,some youth leave home for the homes of friends and relatives, wherethey may be well cared for. "These
are two ends of a continuum ofrunaway/thrownaway episodes which can vary a great deal in theirseriousness and level
of danger," the researchers noted.

Missing Involuntarily, Lost, or InjuredThis category describes missing children who are trying to get homeor
make contact with the parent/caretaker and are unable to do sobecause they are lost, stranded or injured; or children
who aremissing because they are too young to know how to return home or makecontact. Of the estimated 1,315,600 missing
children in 1999(including both those reported missing to authorities and those notreported), 198,300, or 15 percent,
were categorized as involuntarilymissing, lost, or injured.

Investigators will issue a detailed bulletin analyzing thedemographics of this group and the characteristics of these
episodeslater this year.

Missing Benign ExplanationThis category is comprised of children who cannot be classified inany of the prior
categories, but become "missing" because of a benignreason such as miscommunication with their parents. In 1999, theycomprised
43 percent of all children who were reported as missing toauthorities.

Investigators will issue a detailed bulletin analyzing thedemographics of this group and the characteristics of these
episodeslater this year.

"It is vital that parents, and policymakers, understand thecomplexities of the problem of missing children," says
Hammer. "Notall missing children are endangered, and most are not abducted. Thechallenge is figuring out how to differentiate
the innocuous episodesfrom the serious ones. Also, many children become missing because offamily conflicts or maltreatment,
problems that need to be addressedin addition to locating and returning the child home. We believe thisstudy yields
important new data that take an important first step inshaping strategies for keeping children safe."

A guide for parents titled "Personal Safety for Children" developedby the White House and including selected findings
of NISMART-2 isavailable to the public online in both English and Spanish atwww.missingkids.com under the Education and Resources link. The guidewill also be distributed to every school child in America. Thepamphlet
is designed to serve as a resource to help parentsunderstand and talk to their children about the risks and providesafety
tips for protecting against abduction.

The full text of the initial NISMART-2 bulletins (Qs & As, Overviewof Missing Children, Children Abducted by
Family Members, NonfamilyAbducted Children, Runaway/Thrownaway Children) is available at theOffice of Juvenile Justice
and Delinquency Prevention website:http://ojjdp.ncjrs.org/pubs/new.html

Therapies: For Addiction, a Change of VenueOctober 15, 2002 By JOHN O'NEIL - - NY TimesA new drug and changes
in federal regulations should help movetreatment of heroin addiction out of methadone centers and intodoctors' offices,
the author of an article being published today inThe Annals of Internal Medicine says.

Fewer than a quarter of the nation's estimated 800,000 heroin addictsare believed to receive treatment, according
to the article by Dr.David A. Fiellin of the Yale School of Medicine. Many treatmentcenters have long waiting lists,
and many addicts, especially thosestill with jobs and families, wish to avoid the stigma associatedwith drug treatment
centers, Dr. Fiellin said in an interview.

Five years ago, a federal panel concluded that treatment with anopioid agonist - a drug like methadone that undercuts
the euphoriceffort without bringing on withdrawal symptoms - could be effectivewhen combined with counseling. Since
then, efforts have been made tomake such care more accessible, Dr. Fiellin said.

He said the biggest step was the approval last week by the Food andDrug Administration of a new partial agonist,
buprenorphine, whichstudies have shown to be almost as effective in preventing relapse asmethadone.

Buprenorphine has some clear advantages, Dr. Fiellin said. It is lessmood-altering, and when combined with an opioid
blocker it is harderto abuse. That has let it qualify for a less restrictive category ofcontrolled substances, he
said, opening it to office use by trainedphysicians. "Our expectation is that it will increase access totreatment
for a large population of patients," he added.

Other changes in federal regulations are beginning to make itpossible for physicians working in partnership with
drug programs totreat stable methadone patients in regular medical offices.

Dr. Fiellin said studies had shown that office treatment was aseffective as methadone clinics for stable patients
and was moresatisfying. They "felt that they were finally being recognized fortheir stability, by being able to receive
their treatment in a moremedical setting," he said.

Contact: Ming Tai or Tim Parsonsmtai@jhsph.edu 410-955-6878 Johns Hopkins University Bloomberg Schoolof Public HealthMarijuana use linked to hallucinogen useYoung
marijuana smokers more likely to have the opportunity to usehallucinogens A study from the Johns Hopkins Bloomberg School
ofPublic Health provides the first epidemiological evidence that youngmarijuana smokers are substantially more likely
than non-smokers tobe presented with the opportunity to try hallucinogens. Once theopportunity for hallucinogen use
occurs, marijuana smokers are morelikely than non-smokers to actually try it. The study appears in theApril issue
of Drug and Alcohol Dependence.

"Research in the past has focused on the causal relationships ofdrugs, but our study is the first to support the
idea of two separatemechanisms linking marijuana and hallucinogen use -- that ofincreased opportunity and increased
use once given the opportunity,"says lead author Holly Wilcox, a doctoral candidate in the departmentof mental hygiene
at the Johns Hopkins Bloomberg School of PublicHealth. "Insight into this area teaches us about mechanisms thatmight
help guide new progress for prevention of drug problems."

For the investigation, the researchers used self-report data frommore than 40,000 young participants in the 1991
to 1994 NationalHousehold Surveys on Drug Abuse (NHSDA). From this data, they wereable to extract information about
the age at which young people firsthad the opportunity to use different drugs and the age at which theyfirst tried
them. They focused on the availability and use of twodrugs: marijuana (cannabis, reefer, blunts, hash oil, or any otherform
of marijuana use) and hallucinogens (LSD, mescaline, mixedstimulant-hallucinogens, and PCP).

The results showed that by age 21, almost one-half of the teenagerswho had smoked marijuana had a chance to try a
hallucinogen, comparedto only one in 16 of the teenagers who had never smoked marijuana.Within a time period of one
year after the first chance to use ahallucinogen, two-thirds of marijuana smokers actually tried it,compared to only
one in six of the teenagers who had never smokedmarijuana.

"This large difference between marijuana smokers and non-smokers maybe attributed to the social influences in a marijuana
smoker's life.Young people who are using marijuana sometimes develop contacts withillegal drug dealers who may try
to push other drugs like Ecstasy orLSD," explains James C. Anthony, PhD, a professor of mental hygiene,psychiatry,
and epidemiology at the Johns Hopkins Bloomberg School ofPublic Health and School of Medicine. "Also, marijuana smokers
oftenare members of social circles where drug use and experimentation ismore common, and friends are likely to share
drugs. In addition totrying to persuade young people to not use drugs, it may beworthwhile for us to persuade users
to not share their drugs withfriends."

The authors say further research is needed to account for variationsin exposure opportunities experienced by marijuana
smokers and tounderstand why some marijuana smokers choose not to use hallucinogensonce given the opportunity. "Such
research should lead toward newideas for prevention of hallucinogen use," concludes Ms. Wilcox.

Springtime brings out feelings of despair, hopelessness for manyPeak season for suicideMore people kill themselves
at this time of year than any other,though experts aren't sure whyBy Thrity Umrigar Beacon Journal staff writerThe
Beacon JournalAkron OH

On April 25, 1995, Beth Wood took about 40 painkillers with alcoholand went to bed. To her dismay, she was discovered
by herthen-boyfriend early the next morning and rushed to the hospital. Shelived.

Each year, about 30,000 Americans are not so lucky.

And with the arrival of spring, mental health experts have beenbracing themselves for a spike in the number of suicides.

For most people, spring is a season of hope, a time of renewal and rebirth.

But for some, it is a season of despair. More Americans killthemselves in the spring than at any other time of the
year. Suiciderates normally spike in April and again in summer. Contrary topopular belief, suicide rates drop during
the winter holiday season.

An average of 80 Americans kill themselves each day. That's oneperson every 18 minutes.

In 1999, the most recent year for which national statistics areavailable, 29,199 Americans committed suicide. That
same year, therewere 16,899 homicides in the United States.

Another 730,000 people tried to kill themselves in 1999 but were notsuccessful. An estimated 5 million living Americans,
like Wood, haveattempted suicide at some point in their lives.

For all the public awareness campaigns -- for instance, May isdesignated as Suicide Prevention Month -- many myths
still surroundthe issue. The American Association of Suicidology tries to combatthem by presenting such facts as these:*
The majority of suicides -- 72 percent -- are committed by white men.

* White men over age 85 have the highest suicide rate -- 59 per 100,000.

* Suicide is the third-leading cause of death among young people ages15 to 24, following accidents and homicide.
The rate in this agegroup is 10.3 per 100,000.

* Men commit suicide four times more than women, but women attemptsuicide three times more than men.

* The strongest risk factors for attempted suicide in young peopleare depression, alcohol or drug use, and aggressive
or disruptivebehaviors.

Season of death

Experts are not sure why spring becomes a season of death for so manypeople, but they have some guesses.

``In the spring, they expect they'll feel better,'' said BarbMedlock, who runs the support hot line at Portage Path
BehavioralHealth in Akron. ``And they don't. It's a disappointment on top ofother life stresses. It increases their
hopelessness.''

Wood, a 38-year-old Akron resident, recalls how depressed she wasbefore her suicide attempt.

``There was nothing to do, nowhere to go,'' Wood said. ``I washorribly depressed, but I was the most functional depressed
personyou'll ever meet. I would go to work, do what I had to do.''

She had been contemplating suicide for at least six months before herattempt that April.

At the time of her attempt, Wood was living with her boyfriend. Shehad quit her job, her finances were a mess and
she had been estrangedfrom her family for a year. She was convinced that ``nobody wouldmiss me because I turned into
such a worthless person.''

Medlock said many suicides are a cry for help, but that cry may be asvague as a statement like, ``I just don't know
if I can deal withthis anymore.''

``The important message is that 90 percent of people have someemotional problem that's treatable,'' she said. ``People
live theirlives and run into emotional problems they can't solve. Their copingskills are not good. Hopelessness builds
and they think this is a wayof getting away from pain.''

Wood has been on both sides of the suicide continuum. She cringes atthe memory of waking up in the hospital and seeing
her familystanding around her bed. She had believed that killing herself wouldmake it easier for them to go on with
their lives. One look at theirstricken faces told her otherwise.

Her family stood by her. So did her friends, including one who killedhimself last year.

``Prior to my friend's death, I would've said everybody has thechoice to take his own life,'' Wood said. ``I have
a different takeon this now. I think suicide is stupid and selfish.''

Distorted thinking

Yet she remembers how distorted her thinking was at the time.

``You don't feel it's selfish when you're in that place,'' she said.``You're thinking you're going to make things
better (for the peoplearound you).''

``I still think about her with every breath I take,'' Botnick said.``I think about the magic she had in everything
she touched. I feelvery much alone and something's missing.''

In her daughter's memory, Botnick is planning on participating in theOut of the Darkness walk that will commence
in Fairfax, Va., on Aug.17. Participants will walk 26 miles and arrive in Washington, D.C.,the next day.

She is making the walk ``to raise awareness. The whole issue (ofsuicide) is cloaked in silence. This silence has
to be broken. Peoplecan be helped.''

On the first anniversary of her suicide attempt, Wood's mother boughther a ring.

``I look at it as my second birthday,'' Wood said. ``It was the day Iwas able to start again.''

Which is not to say the climb back has been easy. After leaving thehospital, Wood went into a residential treatment
program for twoweeks and then moved in with her mother for a time. She receivedtherapy for months.

``The suicide attempt was the best thing that ever happened to me,''she said. ``It gave me a chance to ask for help.''Thrity
Umrigar can be reached at 330-996-3174 or attumrigar@thebeaconjournal.com

More College-Age Students Victims of Sex Crimes Related to ExcessiveDrinking-(U. South Florida)U-WIRE - April
19, 2002 (U-WIRE) TAMPA, Fla. -- A new report releasedearlier this month said approximately 1,400 deaths and 700,000 sexualassaults,
all alcohol related, occur each year -- a trend that isonly getting worse. Drinking among American college students hasresulted
in many other consequences, too, according to the reportreleased by the National Institute on Alcohol Abuse and Alcoholism.

The NIAAA developed a task force in 1998 to examine these dangerouseffects and consequences that are caused by alcohol.
Mark Goldman, aUniversity of South Florida psychology professor and co-chair for thetask force, worked with 15 college
presidents and 17 otherresearchers who have worked in the field of psychology and alcoholismto help change the culture
of drinking on campus.

"We spent three years reviewing literature, reports on alcohol use incollege and we also looked at the efforts that
were trying to be madein drinking in college," Goldman said.

The drinking consequences are not limited to students who drink. Morethan 600,000 students between the ages of 18
to 24 are assaulted byanother student who was drinking. Also, 400,000 students hadunprotected sex, and more than 100,000
were too intoxicated to knowwhether they consented to have intercourse.

"The consequences of excessive drinking are far too common on manycollege campuses nationwide, and efforts to reduce
high-risk drinkingand its related problems have largely failed," Goldman said.

Goldman worked alongside Rev. Edward Malloy, president for theUniversity of Notre Dame. Both Goldman and Malloy were
a part of theNational Advisory Council on Alcohol Abuse and Alcoholism and werethen appointed to the task force. The
task force created two panels,the Panel on Contexts and Consequences and the Panel on Preventionand Treatment.

Goldman said one of the main reasons for the interest in the taskforce was because of recent reports pertaining to
problems concerningcollege drinking.

"In recent years there has been a few public and media announcementswith drinking," Goldman said. "One, for example,
was a student whodied at (Massachusetts Institute of Technology) MIT due to alcoholinfluence."

According to a related article in the Washington Post, the newnational estimates of alcohol-related deaths and injuries
show thatthe consequences of heavy drinking by some students are far greaterthan previously understood.

The Harvard School of Public Health College Alcohol Study (CAS)conducts an ongoing survey of over 15,000 students
at 140 four-yearcolleges in 40 states each year. The CAS examines high-riskbehaviors, such as heavy drinking and smoking
among college students.

The 2001 rates of binge drinking at 119 CAS colleges were remarkablysimilar to those found at the same institutions
in 1993, 1997 and1999. Nationally two out of five undergraduate college students werebinge drinkers -- a statistic
that hasn't changed since 1993.

Approximately 31 percent of college students responding to a nationalsurvey in 1999 accepted criteria for a diagnosis
of alcohol abuse,according to a new study by the Harvard researchers cited in thereport by the NIAAA's task force.

Emanuel Donchin, chair for the Department of Psychology at USF, saidGoldman has been investigating the issues of
alcoholism for a longtime and deserved the position of co-chair for the task force.

"He is one of the top scholars in this city and in the country on thesubject," Donchin said. "It was only natural
to have picked himbecause he has a large body of research to his credit."

Goldman has worked on several research projects that were providedfederal funding. He is also board certified in
clinical psychologyand a member of the American Psychological Association'sphysiological division and the neuropsychology
division. Goldman hasalso served as an editor on many journal boards that deal withalcoholism and psychology.

Donchin said with all his credentials, he is a distinguishedprofessor at the University of South Florida.

"He teaches graduate and undergraduate students," Donchin said. "Hehas a very large and well-respected program with
research inalcoholism."

Goldman said the task force came out with a report on April 9 andmailed a copy of the report to every college in
the United States forreview. The report included strategies for dealing with the problemwithin the college community,
as well.

"What everyone has to do is get on the same page," Goldman said.

Goldman said with USF being so close to Ybor City there should besome way that the university and the business owners
can worktogether.

Terry Gordon, lieutenant for the University Police, said that USF'salcohol-related arrests have been few this semester.
From Jan. 1 toApril 7, there were six arrests for underage possession of alcohol,12 arrests for driving under the
influence, and there were no arrestsfor zero tolerance. Zero tolerance is an administrative charge thatgoes against
a student's driver's license.

"If a student is driving in the car and is up to the age of 21 and isnot so intoxicated but found with alcohol in
their system, it is zerotolerance," Gordon said.

Gordon said zero tolerance is not as bad as a DUI charge, but thestudent has to go through an administrative hearing
and gets pointson his or her license if under the age of 21.

"We are trying to keep kids from drinking underage," Gordon said.

UP hands out pamphlets to students and their parents at orientation,Gordon said. The pamphlet, Century Council, is
made up of a bunch ofbeverage distributors that target parents.

"They give them advice on what they need to ask and tell their childbefore entering their first year in college,"
Gordon said. The NIAAAtask force report also makes recommendations on a variety ofstrategies to prevent student alcohol
abuse. They also urge that moreresearch should be conducted.

The task force developed what it calls a "Three-in-One framework"that encourages the universities to consider the
broad effects ofcollege drinking. The framework is a four-tier plan that ratesprevention efforts from effective to
ineffective.

Goldman said the force wants to make sure that it not just providesinformation to colleges but also implements concrete
programs to helpthe universities.

"We want to kick off a process that would put something in place tohave colleges have researchers examine the new
programs and measurethat the program works," Goldman said.

"We want a more constructive process."

Breaking Bonds of Addiction: Compulsion Traced to Part of the BrainUSA TODAY - April 18, 2002 Joe Duavit says
he turned to crystal meth, orspeed, in college to help study for exams.

But the powerful upper also gave him a high, and an addiction that consumedhim. He began to steal from his family
to support his habit, going on bingesthat would last for days.

''I ended up in a straitjacket in a psychiatric ward,'' says Duavit, who in1992 finally conquered his addiction.
He now works for Habilitat, a drugtreatment center in Kaneoho, Hawaii.

The urge to take the drug again was the most difficult part of the recoveryprocess, Duavit says. New research may
help explain why drug abusers struggleso much with the compulsion to take such a risky drug again and again.

A scientific study now suggests that compulsion can be traced back to damageto a part of the brain involved in making
good decisions. Yet people such asDuavit do recover -- often with the help of therapy. Studies also now suggestthat
the brain may heal itself after a person stops abusing a drug, a findingthat indicates that recovery may get easier as
time goes on.

Biology of addiction

Such research offers insight into the biology of addiction to meth, cocaineand other illegal drugs. Such knowledge
may one day help researchers find newtreatments to help combat addictions.

Scientists now know these drugs work by telling brain cells to crank out anatural chemical called dopamine. It is
dopamine that tells the brain toregister a sensation of intense pleasure. But in the process, the druginjures those
brain cells and others. Over time, that damage makes it harderfor abusers to get pleasure from anything but the drug.

Methamphetamine, which goes by a number of street names, such as ice, crank,crystal meth or chalk, offers a cheap,
powerful high. Once confined to theWest Coast, the drug has become popular across the country.

That spread worries scientists such as Nora Volkow of the U.S. Department ofEnergy's Brookhaven National Laboratory
in Upton, N.Y. She saysmethamphetamine is one of the most damaging drugs she has studied.

Drugs such as cocaine and meth work by getting brain cells to crank outmassive amounts of the neurotransmitter dopamine.
After dopamine is released,it fits into a specialized protein receptor on other brain cells. The endresult is a rush
of pleasure.

But when it comes to drug abuse, the pleasure comes at a price. Researchersknow that cocaine and heroin reduce the
number of dopamine receptors on braincells. Fewer receptors mean that the addict may need a huge wave of dopamineto
get much of a feeling of pleasure at all.

Volkow's team wondered whether meth could do the same thing. To find out, theteam gave 15 meth abusers injections
of a radioactive substance that fitswith the dopamine receptor. With an imaging method called pos- itron emissiontomography,
or PET, they took snapshots of the brain.

In the December American Journal of Psychiatry , the Brookhaven team reportsthat meth addicts had 15% fewer dopamine
receptors than people who had neverabused the drug.

With fewer dopamine receptors in the brain, the methamphetamine addict maynot get the usual message of pleasure from
everyday activities, says GlenHanson, acting director of the National Institute on Drug Abuse.

This theory suggests that addicts must come back to the drug again and again,because nothing else gives them much
satisfaction.

Meth affects more than just the dopamine receptor. The drug also injuresbrain cells that manufacture dopamine. In
the short term, meth makes cellsrelease dopamine, but over time, the damaged cells produce less and lessdopamine.
That means a meth addict may turn to the drug, seeking to ramp uphis dopamine production, says Wilkie Wilson, an addiction
expert at the DukeUniversity Medical Center in Durham, N.C.

''People take these chemicals to get a pure dopamine release,'' he says. Butthe drugs damage the brain in the process,
a problem that helps sustain theaddiction, he says.

When methamphetamine injures the brain cells that make dopamine, it also setsthe addict up for another risk, one
related to another function that dopamineplays in the human brain. Scientists know dopamine helps people move aboutand
remember new information. A loss of dopamine means addicts may havetrouble with learning things or with motor skills,
Wilson says.

Yet the scientific studies also carry a message of hope for those, such asDuavit, who stop using meth.

Volkow's team studied meth addicts who had stayed off the drug for up to ninemonths. They compared brain scans of
those recovering addicts with scans ofpeople who had never used the drug. In the December issue of the Journal ofNeuroscience
, Volkow's team reports that some brain cells had recovered fromthe damage the drug had done.

A healing process

But when the team gave the addicts a series of memory and motor-skill tests,they did not find a significant improvement
in their abilities. That maysimply mean that the brain needs more time to heal.

Duavit didn't notice any memory problems after he quit meth. But he did haveto learn how to take pleasure in things
that many people take for granted. Hesays he had to learn how to get satisfaction from working hard toward a goal,such
as getting a college degree.

And, over time, Duavit did experience a healing, in his case one that freedhim from a seven-year addiction to meth.
Now as a drug treatment counselor,he looks for another kind of high, one that he gets from helping others breakfree
of drug addiction.

Teen Substance Abuse Could Increase Psychological WoesHealthScout - November 12, 2002 TUESDAY, Nov. 12 (HealthScoutNews)
-- Teensand young adults who abuse alcohol and drugs could be increasing their oddsof psychological troubles down
the road, new research says.

While other studies have confirmed an association between early drug abuseand later psychological disorders, there
has been a chicken-and-eggcontroversy about the link: Is drug and alcohol abuse primarily due topre-existing psychological
disorders, or are the disorders a result of drugand alcohol abuse?

In a new, longitudinal study, researchers at the Mount Sinai School ofMedicine in New York followed more than 700
people, aged 14 to 27, for 14years and found that alcohol and drug use is in itself significantlyassociated with psychological
disorders in the late 20s.

"The fact that we are able to predict this is new, startling and alarming. Itused to be thought that the link only
went the other way," says Dr. David W.Brook, a Mount Sinai psychiatrist and one of the authors of the study.

The results of the study appear in the November issue of The Archives ofGeneral Psychiatry.

In the study, Brook and his colleagues, including his wife and collaboratorDr. Judith Brook, did interviewed 736
people, chosen randomly from upstateNew York communities, aged 14, 16, 22 and 27. The researchers used a standarddiagnostic
questionnaire to measure psychiatric disorders and also assessedthe participants' alcohol, drug and tobacco use.

All interviews were conducted in the participants' homes by trainedinterviewers, and those participants who moved
away were interviewed by phoneor mailed questionnaires. Half the respondents were female and there were nogender differences
in the result. The study is one of several conducted usingdata from authors' long-term "The Children in Community Study,"
which isfunded by the National Institute on Drug Abuse.

Age-appropriate psychological questions using the University of MichiganComposite International Diagnostic Interview
included whether a person haddiminished interest in daily activities, felt excessive fatigue on a dailybasis, had
unexplained weight fluctuation, was in a depressed mood or thoughtabout dying often.

The questions are aimed at diagnosing major depressive disorders, but do notaddress other major psychiatric illnesses,
such as bipolar disorder orschizophrenia.

Participants were also asked to report on their tobacco, alcohol, marijuanaand other illegal drug use. Measures used
for assessment for each categorywere rating systems grading use from none to the maximum of the following:Cigarettes,
one-and-a-half packs daily; alcohol, three or more drinks a day;marijuana and other illegal drugs, daily use.

The results, Brook says, showed that the cumulative frequency of drug use,including alcohol, marijuana and other
illegal drugs, during adolescence andearly adulthood were associated with episodes of major depressive disorders,alcohol
dependence and substance use disorders in the late 20s. In that agegroup, 8.3 percent of participants qualified for a
diagnosis of depressivedisorder, 5.2 percent qualified as having alcohol dependence and 6.1 percentshowed substance
use disorders.

Increased tobacco use was associated with an increased risk for alcoholdependence and substance use disorders but
not with depressive disordersamong those in their late 20s.

"This should be a signal to policy makers as well as concerned parents tolook around and see what's happening," Brook
says.

Frequent cannabis use increases the risk of developing depression andschizophrenia in later life, according to three
studies in thisweek's BMJ.

In the first study of 1,600 students from 44 secondary schools inAustralia, frequent cannabis use predicted later
depression andanxiety, particularly in teenage girls.

Some 60% of participants had used cannabis by the age of 20 and 7%were daily users. After adjusting for use of other
substances, dailyuse in young women was associated with a more than fivefold increasein the odds of later depression
and anxiety. Weekly or more frequentuse as a teenager predicted a twofold increase in later risk.

The second study clarifies earlier findings that cannabis isassociated with later schizophrenia and that this is
not explained byuse of other psychoactive drugs or personality traits. The resultsshow that use of cannabis increases
the risk of schizophrenia by 30%.

The weight of evidence is that occasional use of cannabis has fewharmful effects overall, say the authors. Nevertheless,
these resultsindicate a potentially serious risk to the mental health of peoplewho use cannabis particularly in the
presence of other risk factorsfor schizophrenia. Such risks need to be considered in the currentmove to liberalise
and possibly legalise the use of cannabis in theUnited Kingdom and other countries, they conclude.

In the third study, researchers found that using cannabis inadolescence increases the likelihood of experiencing
symptoms ofschizophrenia in adulthood, with the youngest cannabis users (by age15) at greatest risk. These findings
suggest that cannabis use amongpsychologically vulnerable adolescents should be stronglydiscouraged, while policy
and law makers should concentrate ondelaying onset of cannabis use, say the authors.

The shown dose-response relation for both schizophrenia anddepression highlights the importance of reducing the use
of cannabisin people who use it, write two psychiatry experts in an accompanyingeditorial.

Body-Conscious Boys Adopt Athletes' Taste for SteroidsNovember 22, 2002By TIMOTHY EGAN - - NY TimesCLEARFIELD,
Utah - They want to be buff. They want to beripped. They want to glisten with six-pack abs and granitepecs like the
hulks on Wrestlemania.

But more than ever, American boys are trying to finddesigner bodies not just in a gym but also in a syringe ofillegal
steroids, or a bottle of the legal equivalent froma mall nutrition store, law enforcement officials, doctorsand teenagers
say.

Steroid use has long been widespread among athletes lookingfor a quick way to add strength or speed. Athletes "on
thejuice," as the term goes, can be found in nearly any highschool or college or among the ranks of top professionalathletes.

But now boys as young as 10, and high school students whodo not play team sports, are also bulking up with steroidsor
legal derivatives like androstenedione - known assteroid precursors - simply because they want to look good.The growing
use of such substances, which doctors say canlead to side effects that basically shut down normaladolescent development
in male bodies, has also createdproblems for law enforcement.

The narcotics police who usually spend their days raidingmethamphetamine laboratories in this prosperous countyalong
the Wasatch Mountain front got some idea of themarket demand earlier this year when they broke up a highschool steroid
ring. Three students were caught afterreturning from Mexico in a van with steroids and otherdrugs bought at a veterinary
supply store in Tijuana, thepolice said.

The plan was to sell the steroids - the possession ordealing of which is a felony - to fellow high schoolstudents
throughout Davis County, the police said.

"These are injectable steroids, very powerful, and thesekids weren't just going to sell them to the footballplayers,"
said Dave Edwards, an officer with the DavisMetro Narcotics Strike Force. "They had a lot of customers,kids who will
do anything to get that buff look."

New York has its suburban gyms where some bodybuildersdrink protein shakes laced with steroids orandrostenedione,
known as andro, and California has itsbeach body shops where people take a similar path to whathas been called reverse
anorexia.

But it is in the high schools of middle America, and thegyms that cater to students off campus, where use ofbody-enhancing
drugs has taken off - particularly amongnonathletes. And for all the recent concern about anepidemic of youth obesity,
the mania over instant bulkshows another side of the struggle for self-image.

"Everybody wants to be big now," said Zeb Nava, a senior atClearfield High School who has added nearly 50 pounds
ofmuscle mass over the last two years by weight lifting, hesaid, adding that he had avoided all supplements. "Themajority
now are guys that don't do it for sports. They doit for girls. For the look."

Nearly half a million teenagers in the United States usesteroids each year, according to the latest national surveydone
for federal drug agencies. While the use of otherillegal drugs has fallen or leveled off, the number of highschool
seniors who had used steroids within a monthincreased nearly 50 percent last year, the survey found.

Among high school sophomores, steroid use more than doublednationwide from 1992 to 2000, according to the annualsurvey
used by the National Institute of Drug Abuse.

Another survey, done last year for Blue Cross Blue Shield,found that use of steroids and similar drugs increased
by25 percent from 1999 to 2000 among boys ages 12 to 17. Thisstudy, a national survey of 1,787 students, also found
that20 percent of the teenagers who admitted takingbody-enhancing drugs did it because they wanted to lookbigger,
not because of sports.

Preston Alberts, a senior at Clearfield High who has beenworking with weights in the school gym for three years,said
he had seen a different kind of lifter of late in theweight room: the vanity bodybuilder.

"We notice a lot of kids now, they just want this certaintype of body - with the abs and the ripped chest - and theywant
to get it quick," Mr. Alberts said.

Sales of legal, largely unregulated steroid precursors likeandro have soared among the young, according to recentCongressional
testimony by doctors and officials in thesupplement industry, prompting a move in Congress to havethem treated as
illegal drugs when they are not prescribed.These precursors, which metabolize into steroids onceingested, are perhaps
the main reason why sports nutritionsupplements are the largest-growing segment of the $18billion dietary supplement
industry.

Andro use increased after Mark McGwire, the former St.Louis Cardinals slugger, said he used it. Mr. McGwirecautioned
that people under 18 should not follow hisexample.

Steroid precursors can bought over the counter at healthstores or supermarkets. While the labels say people under18
should not take them, they are aggressively marketedover the Internet with promises like, "You'll get huge!"

Representative John E. Sweeney, Republican of New York,said he found out about the bodybuilding drugs through histeenage
son.

"My 16-year-old son, who goes to a Catholic militaryschool, told me some of his fellow students were usingandro
and he wanted to know what I thought," Mr. Sweeneysaid. "I was stunned. He said some of the kids were takingandro
and getting really big."

Recently, Mr. Sweeney co-sponsored a bill, along withRepresentative Tom Osborne, Republican of Nebraska, to makeover-the-counter
sales of steroid precursors illegal. Mr.Osborne, who was coach of the University of Nebraskafootball team for 25 years,
said the precursors "have thesame effects and dangers as steroids."

Similarly, a number of pediatricians said in Congressionaltestimony last summer that they did not distinguish betweenillegal
steroids and legal precursors.

While some of the products guarantee a rack of ripplingmuscles in five weeks or less, many of these compounds canactually
stifle bone growth, lead to testicular shrinkage,liver tumors and development of male breasts, doctors warn.Some of
these effects can be irreversible, like stoppingbone growth in children who would otherwise continue todevelop, according
to recent medical testimony in Congress.Steroids do this by falsely signaling to the body to stopproducing its own
testosterone.

Here at Clearfield High School about 40 miles north of SaltLake, the school has built a large weight room toaccommodate
the demand by students who want to attain thelook. Classes run all day, with upward of 150 studentslifting weights
at a time.

The principal, Mike Timothy, said he could sometimes tellwhich students were using steroids or precursors not justbecause
their appearance had changed so drastically, butbecause they were also quick-tempered. It is called " 'roidrage."

"Suddenly, you've got some kids who are ready to fight atthe drop of a hat," Mr. Timothy said.

Although none of the students charged with bringingsteroids in from Mexico went to Clearfield, the police saythey
had numerous customers among the students at theschool, and two others in the county. The students wereprosecuted
in juvenile court.

"At first, the parents and some of these school officialswere in denial about what's going on," said Lt. Ted Ellisonof
the narcotics strike force. "But since then, I've hadseveral parents come forth saying they found syringes andpills
at home. Around here, it's such a `wow.' These aregood kids, from good families, no criminal records, creamof the
crop."

Many in Congress are now calling for restrictions onsteroid precursors and other sports supplement drugs.Senator
Orrin G. Hatch, the Utah Republican who pushedthrough the 1994 law, which opened the floodgates tolargely deregulated
sales of dietary supplements, has askedthe Food and Drug Administration to see if steroidprecursors meet the definition
of a controlled substance.

The supplement industry is against the effort to put alegal crimp in the precursor market. While acknowledgingthat
the drugs can be harmful to people under 18, industryofficials say they can be used legitimately by adults, tohelp
recover from muscle injuries, for example, or toimprove strength and endurance. The solution to teenageabuse is to
make sure clerks do not sell them to peopleunder 18, they say.

"I'm not supposed to use this analogy, but cigarettes areout there as well, and we are finally getting goodenforcement
of laws prohibiting sales of them to peopleunder 18," said John Cardellina of the Council forResponsible Nutrition,
a supplement industry trade group.

But young bodybuilders say the pills and solutions thatpromise muscle makeovers are ubiquitous, legal or not.

"Guys know what the side effects are," said Mr. Alberts,the Clearfield senior. "But a lot of them just don't care.It's
like, this is how you get big quick. You get on thejuice."

Suicidal behavior among alcoholics* Alcoholics have a much higher rate of death by suicide than do membersof
the general population.* Those alcoholics with a history of suicide attempts appear to have asignificantly more severe
course of alcohol dependence than other alcoholics.* The fathers, mothers and siblings of alcoholics who had attemptedsuicide
also showed a significantly higher prevalence of suicide attempts.

Contemplating suicide is very common, according to a 1997 article in the NewEngland Journal of Medicine. In fact,
up to one third of the generalpopulation has thought about suicide at some point in their lives.

The strongest predictor of suicide is psychiatric illness; more than 90percent of people who commit suicide have
diagnosable psychiatric illnessesat the time of death, usually depression, alcohol abuse, or both. Thelifetime risk
for suicide completion among alcohol-dependent individuals hasbeen reported to be almost 10 percent, which is five to
10 times greater thanthat found among the general population. A study in the April issue ofAlcoholism: Clinical &
Experimental Research seeks to identify risk factorsfor suicide attempts among a large family-based sample of alcoholics
from theCollaborative Study on the Genetics of Alcoholism (COGA).

"We found that alcohol-dependent individuals with a history of suicideattempts had a significantly more severe course
of alcohol dependence," saidMarc A. Schuckit, principal COGA investigator at the University of CaliforniaSan Diego
site, also of the Veterans Affairs Medical Center, andcorresponding author for the study. "They also had a higher prevalence
ofboth independent and substance-induced psychiatric disorders, as well asother substance dependence." Schuckit speculated
that increased alcoholintake by this subgroup of alcoholics may have led to more severe problems,which may have then
resulted in brain dysfunction, neuropsychological changesand subsequent judgment impairment, an increased likelihood of
mood swings,and alcohol-related violent behavior. All of these factors could havecontributed to life problems, as
well as suicide attempts.

For this COGA investigation, 3,190 alcoholic men and women were givensemi-structured, detailed interviews. Information
about suicidal behavior,socioeconomic characteristics, psychiatric comorbidity, substance-usedisorders and characteristics
of alcohol dependence were obtained from thealcohol-dependent probands (original subjects of the study), their relatives,and
controls (families without a history of alcohol dependence).

Of the total number of alcoholics, 522, or more than 16 percent, had ahistory of ever having attempted suicide, whereas
2,668, or close to 84percent, did not. First-degree relatives (fathers, mothers and siblings) ofindividuals who had
attempted suicide also showed a significantly higherprevalence of suicide attempts than other alcoholics, but - according
toprevious research - no enhanced rate of alcohol dependence, psychiatriccomorbidity, or other substance-use disorder.
This suggests that suicidalbehavior may be transmitted in families independent of alcohol dependence,psychiatric disorders,
or other substance-use disorders.

"Is there a suicide gene? Probably not," said Robert M. Anthenelli, associateprofessor of psychiatry in the College
of Medicine at the University ofCincinnati, and director of substance dependence programs at the CincinnatiVeterans
Affairs Medical Center, "but that's beyond the scope of this paper'sfindings. What this finding does is give some support
for the idea that'suicidality' or suicide attempts seem to run in families. However, familystudies rarely do a good
job of teasing out nature versus nurture, orgenetics versus environment. What this study does nicely is show that asuicidal
'trait' seems to exist independent of substance-abuse disorders aswell as other psychiatric disorders."

Anthenelli added that the size of the study makes the associations foundbetween suicidality and alcohol dependence
more meaningful and believablethan similar findings in previous, smaller studies. "Another strength is thepercentage
of women included, almost 40 percent," he said, "which a lot ofother studies are not always able to achieve." In fact,
he said, some of thegender differences in the findings were notable.

"The odds ratio of alcoholic women making a suicidal attempt was 2.86," hesaid. "This means that an alcoholic woman
has almost a three-fold greaterlikelihood of attempting suicide than a male alcoholic. That's powerful. Italso fits
well with the knowledge that women in the general population makemore suicide attempts than men, even though men have
a higher completionrate."

Schuckit plans to continue with the investigation of suicidality amongalcoholics in order to better understand and
prevent suicide attempts andcompletions among this subgroup. "The underlying theme of this paper," saidSchuckit, "and
of the COGA studies in general, is that alcohol-dependentindividuals who drink will likely have mood problems. Those that
drink a lotwill have major problems." Co-authors of the Alcoholism: Clinical & Experimental Research paperincluded:
U.W. Preuss, T.L. Smith, G.P. Danko, K. Buckman, L. Bierut, K.K.Bucholz, M.N. Hesselbrock, V.M. Hesselbrock, and T. Reich
of the Universityof California San Diego, and the Veterans Affairs Medical Center. The studywas funded by the National
Institute on Alcohol Abuse and Alcoholism and theVeterans Affairs Research Service.

At 2 years, cocaine babies suffer cognitive development effectsResearchers also find tobacco has negative effects
on motor developmentCLEVELAND - Scientists know the effects of cocaine on the adult brain andcardiovascular systems.
Now there is a growing body of research documentingthe effects of prenatal cocaine exposure on infants, which is raising
publichealth concerns about the long-term cognitive and developmental outcomes forthese children.

A study published by Case Western Reserve University School of Medicine,MetroHealth Medical Center, and University
Hospitals of Cleveland researchersin the April 17 issue of the "Journal of the American Medical Association,""Cognitive
and Motor Outcomes of Cocaine-Exposed Infants," looks at howprenatal cocaine exposure affects child developmental outcomes.
The study wasconducted by Lynn T. Singer, Ph.D., Robert Arendt, Ph.D., Sonia Minnes,Ph.D., Ann Salvator, M.S., and
H. Lester Kirchner, Ph.D., all of the CWRUSchool of Medicine, Department of Pediatrics; Kathleen Farkas, Ph.D., CWRUMandel
School of Applied Social Sciences; and Robert Kliegman, M.D., MedicalCollege of Wisconsin, Milwaukee, Wis.

CWRU researchers followed 415 cocaine-exposed infants born at MetroHealthMedical Center in Cleveland to determine
how prenatal cocaine exposureaffects child developmental outcomes. They were compared to non-exposedinfants on cognitive
and motor development until age 2. What they found,according to Singer, was that prenatal cocaine exposure does affect
a child'scognitive development, but not motor development. However, tobacco exposurehad negative effects on motor
development.

There have been previous studies in this area, but their findings arecontradictory. While some studies have found
generalized developmental delaysin cocaine-exposed infants, other studies have not demonstrated differencesor found
only subtle cognitive effects. Those studies, CWRU researchers say,are flawed for several reasons, including high dropout
rates, small samplesizes, ignored negative environmental factors, lack of biologic measuresrevealing exposure severity,
incorrect sample populations and outdateddevelopment scales.

This study is the first to document the negative effects on cognitivedevelopment in a scientifically rigorous manner.
Singer, professor ofpediatrics and psychiatry, and interim provost and CWRU vice president, saidthe study was unique
because it had measures of both the mothers' self reportof their drug use prenatally, as well as infant meconium, which
provided aphysical measure of the amount of drug exposure. The study also controlledfor many more factors in the environment
than prior studies, includingstimulation levels in the home, mothers' vocabulary and mental health statusand characteristics
of foster caregivers. The team used newly standardizedversions of the major infancy development tests. And they were able
tomaintain more than 90 percent of the participants during the study, and attwo years, 100 percent of the sample had
at least one follow-up visit.

Mothers and infants were recruited between 1994 and 1996 from a high-riskpopulation screened for drug use. Urine
samples were obtained immediatelybefore or after labor and delivery, and analyzed for the presence of cocainemetabolites,
cannabinoids, opiates, PCP and amphetamines. Urine tests fordrugs were performed by the hospital on all women who received
no prenatalcare, appeared to be intoxicated or taking drugs, had a history with theDepartment of Human Services in
previous pregnancies, or self-admitted orappeared to be high risk for drug use after interview by hospital staff.Meconium
was collected in the hospital from infants' diapers and screened fordrugs.

Researchers initially identified 647 mothers and infants for the study,excluding 232 for various reasons. Infants
were seen at the researchlaboratory at 6.5, 12 and 24 months and administered the widely used BayleyMental and Motor
Scales of Infant Development (BSID II) standardizedassessments. The scales assigned infants a standard score reflecting
memory,language and problem-solving abilities, as well as measurements of gross andfine motor control and coordination.

Researchers found that for all trimesters, cocaine-using women used alcohol,marijuana and tobacco more frequently
and in higher amounts than non-users.Cocaine-using women were found to be older, had more children and were lesslikely
to have had prenatal care. They also were less likely to be married;had lower vocabulary, block design and picture completion
scores; and higherpsychological distress scores.

The study also found that cocaine-exposed infants had lower gestational age,birthweight, head circumference and length
than non-exposed infants. Therewere more preterm, low birthweight and small for gestational age infants inthe exposed
group.

Researchers also found that the rate of mental retardation in cocaine-exposedchildren at age 2 (13.7 percent v. 7.1
percent in the non-exposed group) is4.89 times higher than expected in the general population. And the percentageof
children with mild delays (37.6 percent in the exposed group v. 20.9percent in the non-exposed group) requiring intervention
was almost doublethe rate of the high risk, non-cocaine group. Researchers speculate it islikely that these children
will continue to have learning problems and anincreased need for special educational services at school age.

Another important note from the study is that cognitive delays could not beattributed to exposure to other drugs
or a large number of other variables,including inadequate prenatal care, caregiver or birth mother intelligence,psychological
distress, postnatal drug exposure or a low quality homeenvironment.

Singer said the team is concerned that the study data will be misinterpretedand used to punish women or to remove
children from their families.

"Prosecution of women will not address the problems of alcohol and drugabuse," Singer said. "In fact, our study indicates
that tobacco exposure alsohas significant negative effects on infant development. Our findings alsoindicate that the
quality of stimulation and environmental intervention canhave a large effect on children's mental development independent
of cocaineor other drug exposure."

About one million children have been born after fetal cocaine exposure sincethe mid-1980s, when the "crack epidemic"
emerged with the marketing of acheap, potent, easily available, smokeable form of cocaine.

"We hope that this study will convince public policy and health providersthat there needs to be a major emphasis
on the provision of drug treatment,including smoking cessation, and mental health services for women -especially poor
women who are currently underserved," Singer said. This study was supported by grants from the National Institute on Drug
Abuseand the General Clinical Research Center.

Parent's Depression Ups Kid's Risk of Anxiety Wed Apr 17, 6:19 PM ETNEW YORK (Reuters Health) - Having at least
one parent with major depressionincreases a child's risk for depression as well as substance abuse andanxiety disorders
in late adolescence and early adulthood, new study findingsshow. What's more, the child's depression is likely to be more
severe thanthe parent's, a team of German researchers report.

"This study has once more demonstrated that offspring of depressed parentsconstitute an important high-risk group,"
write lead study author Dr.Roselind Lieb, of the Max Planck Institute of Psychiatry in Munich, Germanyand colleagues.

"Specifically, the early detection of mental health problems in offspring ofdepressed parents seems to be crucial,
as this would allow the treatment ofearly manifestation of mental problems before they cause clinicalimpairment,"
the authors add.

The study results are based on surveys of 2,427 German youth, aged 14 to 24years, and their parents.

Forty-two percent of the mothers and 23% of the fathers were either diagnosedwith major depression or experienced
at least one depressive episode, theinvestigators report in the April issue of Archives of General Psychiatry.For
one third of the study sample, only the mother had major depression, butfor 16%, both parents were affected.

A follow-up survey, conducted 3.5 years after the initial survey, revealedthat nearly one in five offspring had experienced
at least one episode ofmajor depression and about 4% had symptoms of lifetime dysthymia--a milder,chronic form of
depression, Lieb and colleagues report. Those with at leastone depressed parent had a roughly three-fold greater risk
of depression thantheir peers with non-affected parents.

Further, children of depressed parents had an earlier onset of depressivedisorders and more severe depression than
children of nonaffected parents.They also reported having more depressive episodes, being more impaired intheir social
and leisure activities and seeking more treatment for depressionthan did their peers, study findings indicate.

What's more, in addition to a higher rate of depressive disorders, childrenof depressed parents also had higher rates
of substance abuse and dependencedisorders and anxiety disorders, such as obsessive-compulsive disorder, thandid their
peers with nondepressed parents, the investigators report. Thosewith one depressed parent were generally at similar risk
for the variousmental disorders to those with two depressed parents.

Overall, 43% of the youth reported having substance use disorders, includingnicotine dependence and drug and alcohol
abuse and dependence, and 35%reported having anxiety disorders, study findings indicate. Those with atleast one depressed
parent were reportedly 40% more likely to have asubstance abuse disorder and 60% more likely to have an anxiety disorder
thanindividuals with nondepressed parents.

"Major depression in parents increases the overall risk in offspring foronset of depressive and other mental disorders
and influences patterns of thenatural course of depression in the early stages of manifestation," theresearchers conclude.SOURCE:
Archives of General Psychiatry 2002;59:365-374.

Treat addicts' mental illnessMarilyn Elias USA TODAYMental disorders are common among alcoholics and drug
abusers, buttheir mental illness and addictions are seldom treated at the sametime, which prevents many from recovering
from either, says a reportsent to Congress today.

And the government must take the lead in tearing down the''firewall'' between programs that treat addiction and those
thattreat mental illness, the report concludes.

People who have mental illness and are substance abusers havetraditionally been considered exceptions, ''but it's
time to getreal,'' says Charles Curie of the Substance Abuse and Mental HealthServices Administration, which wrote
the report at Congress' request.

About one-third of drug and alcohol abusers have mental disorders,Curie says, and adults with mental illness are
three times morelikely than others to be substance abusers. An estimated 7 million to10 million Americans have mental
and addictive disorders, he says.There's strong evidence that integrated programs work best for them.

But that's going to take a major overhaul of the nation's treatmentsystem. ''Virtually all programs are designed
for one or the other,''says psychiatrist Kenneth Minkoff, a clinical professor at Harvard.People with both problems
''have poor outcomes at higher cost, andthey're more likely to end up in the corrections system.''

A recent study of the Pennsylvania state prison system found that 85%of inmates had addictions, and half of them
had mental disorders aswell. ''That's typical of prison systems nationally,'' Curie says.''And we know if these inmates
recover from the disorders, they'reunlikely to repeat crimes.''

In the past few years, states have started some model integratedprograms, but the pace needs to quicken, he says.
The report listsseveral key steps the health services administration will take. Amongthem:* Federal financial
incentives that will spur states to tryintegrated programs.

* Incentives to combine therapy with medication in long-termtreatment plans that help patients find employment and
housing.

* A national summit next year for consumer advocates and experts intreatment and criminal justice.

* A ''tool kit'' to help local agencies replicate excellent programs.

In Connecticut, a Yale study showed that heroin addicts were far morelikely to drop out of methadone treatment if
they were depressed orhad anxiety disorders. One-third of the state's methadone treatmentprograms have since added
psychiatric screenings and treatment. Thathas kept more clients in the program and off heroin, sayspsychologist Tom
Kirk, Connecticut's commissioner for mental healthand addiction services.

''We have to change the programs to fit what people need, not try tofit the people into programs,'' he says. ''It's
better value becausepatients are more likely to recover.''

U.S. Pushes Heroin Addiction TreatmentAssociated Press - December 10, 2002 WASHINGTON (AP) - Federal health officials
launched an education campaign Tuesday to let doctors and heroin users know there's a new medication that can help curb
addicts' cravings - and for the first time, it can be prescribed in doctor's offices instead of drug-treatment clinics.

The Food and Drug Administration approved buprenorphine in October, an alternative to methadone in helping people
kick addiction to heroin and similar opioids, drugs also found in prescription painkillers.

Now, the Substance Abuse and Mental Health Services Administration is trying to spread the word.

Methadone is the most common treatment for opioid addiction, but it can be dispensed only in a few special drug-treatment
clinics. Only about 20 percent of heroin addicts receive it.

Buprenorphine, in contrast, can be prescribed in doctor's offices - as long as the physician qualifies. The key:
Doctors must seek a government waiver allowing them to prescribe buprenorphine after completing eight hours of mandatory
training.

So far, more than 2,000 doctors have been trained to use buprenorphine and about 300 have received waivers to begin
prescribing, according to SAMHSA.

To increase those numbers - and let addicts know about the new option - the drug abuse agency plans to hold public
meetings in Baltimore, Boston, Chicago, Dallas, Detroit, Miami, New Orleans, New York/Newark, N.J., Portland, Ore.,
Salt Lake City, San Francisco, Seattle, Wilmington, Del./Philadelphia and San Juan, Puerto Rico.

Buprenorphine, a tablet dissolved under the tongue, works by blocking the same brain receptors that heroin targets,
but without heroin's high and with weaker narcotic effects than methadone.

Survey: Drug Use by U.S. Teens DeclinesBy SIOBHAN McDONOUGH, Associated Press WriterWASHINGTON - American
teenagers are cutting their use of illicitdrugs, cigarettes and alcohol, said an annual survey for thegovernment released
Monday.

The downside: A large number of young people still using drugs, saidLloyd D. Johnston, who directed the study by
the University ofMichigan's Institute for Social Research.

"There's a smorgasbord of drugs that are out there," said Johnston."Very few drugs leave the table, but there are
always new ones beingdiscovered and put forward, like Ecstasy."

Ecstasy, also known as MDMA, is a synthetic drug considered parthallucinogen and part amphetamine that has been linked
to brain,heart and kidney damage. It became popular over the past decade atdance parties known as raves for the energy
and euphoria it givesusers.

The survey of 8th-, 10th- and 12th-graders has been done for theDepartment of Health and Human Services (news - web
sites) for 28years.

Results from the 2002 Monitoring the Future study showed more thanhalf of 12th graders have used an illicit drug.
Thirty percent of12th-graders have used some drug other than marijuana, and 11 percenthave used Ecstasy.

Still, those figures are down from recent years. For example, Ecstasyuse among 10th-graders in the past year declined
from 6.2 percent to4.9 percent.

"As youngsters came to see it as more dangerous to use, they movedaway from it," Johnston said. In 2002, 52 percent
of 12th-gradersnoted a great risk of harm associated with Ecstasy, up 14 percentagepoints from 2000 figures.

The survey, funded by the National Institute on Drug Abuse, trackedillicit drug use and attitudes among 44,000 students
from 394 schools.

Findings include:Percentages of 8th- and 10th-graders using any illicit drug declinedand were at their lowest
level since 1993 and 1995, respectively.

Marijuana use decreased among 10th graders, and in the past year, therate of use of 14.6 percent among 8th-graders
was the lowest levelsince 1994, and well below the recent peak of 18.3 percent in 1996.Roughly 30.3 percent of 10th
graders reported marijuana use in 2002,compared with 34.8 percent in 1997.

LSD use decreased significantly among 8th-, 10th- and 12th-graders.LSD use by 12th-graders reached the lowest point
in the last 28 years.

Use of cocaine and heroin remained stable.

Cigarette smoking decreased in each grade, expanding on a recenttrend. There has been a 50 percent decline since
its peak year in1996.

John Walters, director of the White House's Office of National DrugControl Policy, said the survey shows that drug
prevention effortsare working.

"Drug use by our young people is headed down to levels that wehaven't seen in years," Walters said. "This is very
good news forcommunities across America."On the Net:www.whitehousedrugpolicy.gov

ANN ARBOR, MI - New research results strongly suggest that cocainebites the hand that feeds it, in essence, by harming
or even killingthe very brain cells that trigger the "high" that cocaine users feel.

This first-ever direct finding of cocaine-induced damage to key cellsin the human brain's dopamine "pleasure center"
may help explain manyaspects of cocaine addiction, and perhaps aid the development ofanti-addiction drugs. It also
could help scientists understand otherdisorders involving the same brain cells, including depression.

The results are the latest from research involving postmortem braintissue samples from cocaine abusers and control
subjects, performedat the University of Michigan Health System and the VA Ann ArborHealthcare System. The paper will
appear in the January issue of theAmerican Journal of Psychiatry.

"This is the clearest evidence to date that the specific neuronscocaine interacts with don't like it and are disturbed
by the drug'seffects," says Karley Little, M.D., associate professor of psychiatryat the U-M Medical School and chief
of the VAHS AffectiveNeuropharmacology Laboratory. "The questions we now face are: Are thecells dormant or damaged,
is the effect reversible or permanent, andis it preventable?"

Little and his colleagues report results from 35 known cocaineabusers and 35 non-drug users of about the same age,
sex, race andcauses of death. Using brain samples normally removed during autopsy,the researchers measured several
indicators of the health of thesubjects' dopamine brain cells, which release a pleasure-signalingchemical called dopamine.
The cells interact directly with cocaine.

The team looked at levels of a protein called VMAT2, as well asVMAT2's binding to a selective radiotracer molecule,
and overalldopamine level.

In all three, cocaine users' levels were significantly lower thancontrol subjects. Levels tended to be lowest in
cocaine users withdepression.

The paper gives the most conclusive evidence yet that dopamineneurons are harmed by cocaine use, because it uses
three molecularmeasures that provide a trustworthy assessment of dopamine neuronhealth.

Dopamine, Little explains, triggers the actions required to repeatprevious pleasures. It's not only involved in drug
users' "high" - ithelps drive us to eat, work, feel emotions, and reproduce. Normally,when something pleasurable happens,
dopamine neurons pump thechemical into the gaps between themselves and related brain cells.Dopamine finds its way
to receptors on neighboring cells, triggeringsignals that help set off pathways to different feelings orsensations.

Then, the dopamine is normally brought back into its home cell,entering through a gateway in the membrane called
a transporter.While our brain waits for another pleasurable stimulus - a good meal,a smile from a friend, a kiss -
dopamine lies waiting inside theneuron, sequestered in tiny packets called vesicles. VMAT2 acts as apump to pull returning
dopamine into vesicles.

When it comes time for another dopamine release, the vesicles mergewith the cell membrane, dumping their contents
into the gap, orsynapse, and the pleasure signaling process begins again.

Dopamine neurons in the brain's pleasure center die off at a steadyrate over a person's lifetime. Severe damage is
a hallmark ofParkinson's disease, causing its loss of movement control. "As thewords themselves suggest, there's an
intimate connection betweenmotion and emotion," says Little. "Emotion puts you in motion --they're pre-activity preparations.
It's not surprising that the basalganglia, where these dopamine neurons are, is very active in'emotional states.'"

When first taken, cocaine has a disruptive effect on the brain'sdopamine system: It blocks the transporters that
return dopamine toits home cell once its signaling job is done. With nowhere to go,dopamine builds up in the synapse
and keeps binding with other cells'receptors, sending pleasure signals over and over again. This helpscause the intense
"high" cocaine users feel.

Since the dopamine system helps us recognize pleasurable experiencesand seek to repeat them, cocaine's long-term
dopamine effects likelycontribute to the craving addicts feel, and the decreased motivation,stunted emotion and uncomfortable
withdrawal they face.

In recent years, many researchers have come to suspect that chroniccocaine use causes the brain to adapt to the drug's
presence byaltering the molecules involved in dopamine release and reuptake, andin the genetic instructions needed
to make those molecules. Littleand his colleagues are studying the effects of long-term cocaine useon the brain at
a molecular level, in an attempt to explain theeffects seen in cocaine users and addicts.

In several studies, including the current one, they've usedpostmortem samples of brain tissue from known cocaine
users who wereusing the drug at the time of their deaths, and from well-matchedcontrol subjects. They focused in on
the striatum, an area of thebrain with the highest concentration of dopamine neurons.

With approval from the U-M Institutional Review Board and appropriateconsent, they interviewed relatives and friends
of the subjects, andasked about the subjects' alcohol use, mental illness and othercharacteristics.

The team previously showed that cocaine users have higher numbers ofdopamine transporters, suggesting that the cells
tried to make morereturn gateways to compensate for blocked ones. Recently, they showedin cell cultures that cocaine
causes more dopamine transporters totravel from the interior of a cell to the membrane, increasing theoverall dopamine
uptake level.

The data provide support for the idea that chronic cocaine abuseleads to a phenomenon seen in animals, called allostasis
of reward.With extended use of cocaine, the brain's response to the drug is"reset", and drug-taking once pursued for
the pleasure it causedbecomes drug-taking to avoid the negative feelings associated withthe absence of cocaine.

The new data suggest this same phenomenon occurs in human cocaineusers, and is quite pronounced at the neurochemical
level. Theexperiment sheds light on the molecular mechanisms involved asdopamine-producing brain cells try to adapt
to a cocaine-drenchedenvironment.

VMAT2 protein levels, measured through the use of specific antibodiesthat bind to the protein, are not as affected
by other factors asdopamine transporters are. VMAT2 binding availability, measuredthrough a unique radioactive tracer
developed by U-M nuclear medicinespecialists, is another assessment of VMAT2 presence and activity.And the overall
dopamine level, measured through liquidchromatography, shows how much of the chemical was available at thetime of
death.

On the whole, all three were significantly lower in cocaine usersthan in non-drug users. A history of alcohol abuse
in cocaine usersor controls did not affect the difference significantly.

Levels of VMAT2 protein were lowest in the seven cocaine users withmood disorders that may have been caused by cocaine
use. Researchershave found that depressed cocaine users have more severe addictionand mental health problems than
non-depressed users. Littlehypothesizes that the decreased dopamine vesicles and increasedtransporters may contribute
to cocaine-induced depression and otherdepressive disorders. This may explain why depressed cocaine usersare less
likely to respond to some depression treatments.

In all, Little says, "We could be seeing the result of the brain'sattempt to regulate the dopamine system in response
to cocaine use,to try to reduce the amount of dopamine that's released by reducingthe ability to collect it in vesicles.
But we could also be seeingreal damage or death to dopamine neurons. Either way, this highlightsthe fragility of these
neurons and shows the vicious cycle thatcocaine use can create." New treatments will have to break thatcycle, he adds,
and the new findings may help steer clinicalresearchers.

He also emphasizes that the vulnerable nature of dopamine neurons isimportant in understanding the moods and actions
of normal adults asthey age and lose dopamine neurons naturally. Considerable evidencesuggests that uncontained dopamine
may be mildly toxic over time.

In future research, Little and his colleagues hope to look fordifferences in the number of dopamine neurons in the
subjects' brainsamples, and to study gene activity in the cells of cocaine users andcontrol subjects. They also hope
their results will help otherresearchers study living cocaine users and look for signs ofdecreased VMAT2 levels.###

In addition to Little, the study's authors are David Krolewski, M.S.;Lian Zhang, Ph.D.; and Bader Cassin, M.D. U-M
nuclear medicineresearcher Kirk Frey, M.D., led the team that developed theradioactive tracer used to measure VMAT2
binding levels. The studywas funded by the National Institute on Drug Abuse of the NationalInstitutes of Health, and
by a VA Merit Award.Reference: American Journal of Psychiatry 160:1-9, January 2003.

Teen drug use associated with psychiatric disorders later in lifeChildren who start to use alcohol, marijuana
or other illicit drugsin their early teen years are more likely to experience psychiatricdisorders, especially depression,
in their late 20's.

Although teens who started smoking at an early age were at increasedrisk for alcohol dependence and substance use
disorders in their late20's, they did not appear to be at an increased risk for depressionor other psychiatric disorders.
However, initiating tobacco use inlate adolescence was associated with depression and other psychiatricdisorders in
the late 20s.

These findings are based on a 22-year study that tracked theself-reported substance abuse and health histories of
736 youthsthrough their early-and mid-teen years into early adulthood.Scientists from the Mount Sinai School of Medicine
and ColumbiaUniversity started collecting data on the children in 1975, when thesubjects were one through 10 years
of age. Four follow-up interviewswere conducted: in 1983, 1986, 1992, and 1997, when the average agesof the subjects
were 14, 16, 22, and 27 years.

During mid to late adolescence, 18.8 percent of the subjects reportedmoderate to heavy tobacco use; 6.2 percent reported
moderate to heavyalcohol use; 17.6 percent reported moderate to heavy marijuana use;and 3.4 percent reported moderate
to heavy use of other illicitdrugs. During young adulthood, these percentages increased to 35.4,13.0, 18.4, and 3.7,
respectively.

In 1997, when the subjects were in their late 20s, 8.3 percentqualified for a diagnosis of a major depressive disorder
(MDD), 5.2percent were alcohol dependent, and 6.1 percent had a substance usedisorder. Heavy alcohol, marijuana, and
other illicit drug use weresignificantly related to later psychiatric disorders. About 85percent of the individuals
diagnosed with MDD in their late 20s hadused marijuana when they were younger and more than 66 percent had aprior
history of alcohol and/or other illicit drug use.

WHAT IT MEANS: This study adds to the growing body of knowledge aboutthe complex relationship between drug abuse
and psychiatricdisorders. Such findings will be useful in efforts to develop moreeffective prevention and treatment
interventions for individuals atrisk for these co-occurring conditions.Dr. David Brook and colleagues published the
study, which wassupported by the National Institute on Drug Abuse, in the November,2002 issue of the Archives of General
Psychiatry.

Study finds 1,400 college student deaths annually related to alcoholAssociated Press - April 09, 2002 WASHINGTON
(AP) - An estimated1,400 college students are killed every year in alcohol-relatedaccidents, according to a study
released Tuesday that researcherscall the most comprehensive look ever at the consequences of studentdrinking.

The researchers say the figures show that college drinking needs toseen as a major health concern.

``Historically, I think there has been the view that whatever collegestudents are doing, it's not that serious a
problem, it's a rite ofpassage,'' said Kenneth J. Sher, a psychology professor at theUniversity of Missouri-Columbia.

The study by the federally supported Task Force on College Drinkingestimated that drinking by college students contributes
to 500,000injuries and 70,000 cases of sexual assault or date rape. Also,400,000 students between 18 and 24 years
old reported having hadunprotected sex as a result of drinking.

The study does not say whether the problems are increasing ordecreasing. A Harvard School of Public Health survey
released lastmonth reported that more students are abstaining from alcohol, butlevels of binge drinking - having at
least four or five drinks at asitting - are the same as in the early 1990s.

The new report was one of 24 studies commissioned by the task forceof college presidents, scientists and students
convened by theNational Institute on Alcohol Abuse and Alcoholism. The institute ispart of the National Institutes
of Health.

Most of the papers will be published in the forthcoming March issueof the Journal of Studies on Alcohol.

Researchers integrated various databases and survey results to reachtheir findings.

Motor vehicle fatalities were the most common form of alcohol-relateddeaths. The statistics included college students
killed in caraccidents if the students had alcohol in their blood, even if thelevel was below the legal limit.

Students who died in other alcohol-related accidents, such as fallsand drownings, were included. Those who died as
a result of homicidesor suicides were not.

Chief researcher Ralph Hingson of the Boston University School ofPublic Health said he believes the estimates are
more likely to betoo conservative than overstated.

``I think actually getting the numbers out will help the publicunderstand that this is a very large problem, perhaps
a largerproblem than people might have otherwise thought,'' he said.

Overdoses and Deaths From Abuse of Drug Methadone Are UpBy PAM BELLUCKPORTLAND, Me. - Methadone, a drug long
valued for treating heroinaddiction and for soothing chronic pain, is increasingly being abusedby recreational drug
users and is causing an alarming increase inoverdoses and deaths, federal and state officials say.

In Florida, methadone-related deaths jumped from 209 in 2000 to 357in 2001 to 254 in just the first six months of
2002, the latestperiod for which data are available.

"Out of noplace came methadone," said James McDonough, director ofthe Florida Office of Drug Control. "It now is
the fastest risingkiller drug."

In North Carolina, deaths caused by methadone increased eightfold, to58 in 2001 from 7 in 1997 - an "absolutely amazing"
jump, saidCatherine Sanford, a state epidemiologist.

In Maine, methadone was the drug found most frequently in people whodied of overdoses from 1997 to 2002. It was found
in almost a quarterof the deaths. In the first six months of last year, methadone killed18 people in Maine, up from
4 in all of 1997. Dr. John H. Burton,medical director for Maine Emergency Medical Services, said hospitalemergency
rooms were seeing "a tidal wave" of methadone-related cases.

The increase in methadone overdoses and deaths has floored many drugexperts because methadone, which does not provide
a quick or potenthigh, has long been considered an unlikely candidate for substanceabuse. It can be hours before a
user feels any effect, and it worksmore like a sedative than a stimulant.

And because methadone is considered such an important and affordabletool for treating addiction and pain, health
and law enforcementofficials are facing a quandary: how to stop methadone abuse withoutcurtailing its valuable uses
- and especially without driving addictsback to drugs like heroin.

"We've got years of experience with methadone and suddenly we've gotthis problem," said Dr. H. Westley Clark, director
of the federalCenter for Substance Abuse Treatment. "We realize that lives arebeing lost and we're trying to stop
that. But we're trying not to doquick fixes that will cause us more problems."

The surge in methadone abuse appears linked to several factors,including the growing abuse of heroin and OxyContin,
a powerfullyaddictive prescription painkiller. Health and law enforcementofficials are reporting that some of these
addicts are turning tomethadone when they cannot get the other drugs.

At the same time, methadone has become more available. Physicians areincreasingly prescribing it for pain relief,
in part because lawenforcement officials have been cracking down on OxyContin, and moremethadone clinics have sprung
up to treat the growing number ofheroin addicts.

"The availability of methadone for treatment and pain has put peoplewho would not normally be in a position to divert
drugs in thatposition," said Sgt. Scott J. Pelletier, who works for the Maine DrugEnforcement Agency handling drug
cases in Portland and CumberlandCounty, where methadone caused at least 30 deaths in 2002, accordingto the state medical
examiner's office.

University of Illinois at ChicagoAlcohol dependence linked to chemical deficitAnxiety has long been linked to
substance abuse. It is the key psychological factor driving the impulse to drink alcohol and one of the first symptoms
of alcohol withdrawal.

Now, researchers at the University of Illinois at Chicago have discovered they can control the urge to drink in experimental
animals by manipulating the molecular events in the brain that underlie anxiety.

The study is published in the current issue of Alcoholism: Clinical and Experimental Research, the nation's premier
journal covering substance abuse.

The researchers found that a particular protein in the amygdala -- the area of the brain associated with emotion,
fear and anxiety -- controlled the drinking behavior of laboratory animals.

Rats that were chronically fed alcohol showed high levels of anxiety when alcohol was withdrawn from their diet.
In the early phases of withdrawal, levels of the active form of a protein called CREB were low in certain areas of
the amygdala.

However, when alcohol was present in the bloodstream, or when normal levels of active CREB were restored experimentally,
anxiety behaviors in the alcohol-dependent animals vanished.

"Some 30 to 70 percent of alcoholics are reported to suffer from anxiety, and depression -- drinking is a way for
these individuals to self-medicate," said Subhash Pandey, associate professor of psychiatry and director of neuroscience
alcoholism research at UIC. "If we can control the psychological symptoms, perhaps we can help many of the millions
of Americans who are victims of alcohol addiction."

CREB, or cyclic AMP responsive element binding protein, when activated, regulates the manufacture of a brain protein
called neuropeptide Y. Low levels of active CREB or of neuropeptide Y correlated with symptoms of anxiety and excessive
alcohol consumption, the scientists found.

In normal rats, the researchers blocked production of neuropeptide Y. With lower levels of neuropeptide Y, the animals
showed signs of anxiety and their alcohol consumption increased. When levels of neuropeptide Y were restored by infusing
it into the central amygdala, the rats' excessive drinking behavior ceased.###

The UIC study was supported by the Department of Veterans Affairs and the National Institute on Alcohol Abuse and
Alcoholism.

According to NIAAA, an estimated 18 million Americans suffer from alcohol problems. Alcohol and drug abuse cost the
economy roughly $276 billion per year.

Other researchers involved in the UIC study were Adip Roy and Huaibo Zhang, postdoctoral research associates in psychiatry.

Study Finds Link Between Early Pot Use and Lasting Cognitive Deficits - But Is Pot Itself the Culprit?AScribe
Newswire - April 01, 2003 BELMONT, Mass., April 1 (AScribe Newswire) -- A new study in the latest issue of Drug and Alcohol
Dependence indicates an association between early use of cannabis (marijuana) and persisting cognitive deficits.

Led by Harrison Pope, Jr., MD, director of the Biological Psychiatry Laboratory at McLean Hospital, the researchers,
from McLean and the National Institute on Drug Abuse (NIDA), compared 122 heavy users of cannabis with 87 minimally
exposed control subjects. The 122 heavy users had smoked a median of about 15,000 separate times in their lives; the control
subjects had smoked a median of only 10 times.

Among the 122 cannabis users, 69 began smoking the drug before age 17 (early-onset group) and 53 began after age
17 (late-onset group). At the time of the neuropsychological assessments, all cannabis use had stopped for at least
28 days.

The authors found that early-onset cannabis users exhibited poorer cognitive performance than late-onset users and
control subjects. Statistical analyses, which adjusted for age, gender, ethnicity and family variables, indicated that
early-onset users differed significantly from late-onset users and control subjects on several measures of cognitive function,
most notably in verbal IQ. After adjusting for verbal IQ, however, virtually all of the differences between the early-onset
users and the late-onset users disappeared. These results suggest that a combination of social and/or biological factors
may lead to an association between early use of cannabis and deficits in verbal cognition.

The authors offer three competing explanations for these findings: 1) Cannabis might have a toxic effect on the developing
brain of young users; 2) People who begin smoking cannabis at a young age may have lower cognitive abilities initially,
before they ever tried cannabis; or 3) Young-onset cannabis users may not learn the cognitive skills required for the
tests, as they acquire less education and have less familiarity with mainstream culture.

"Any single explanation, or combination of the three, might fit the facts of the study," said Pope.

"Our results show how difficult it is to disentangle the causes of cannabis-associated cognitive deficits."

Co-authors of the study include Amanda Gruber, MD, James I. Hudson, MD, ScD, Geoffrey Cohane, BA and Deborah Yurgelun-Todd,
PhD, from the Biological Psychiatry Laboratory and Cognitive Neuroimaging Laboratory of McLean Hospital, and Marilyn
Heustis, PhD, from the Intramural Research Program at NIDA.

Brain Signal Prompts Addictive BehaviorUnited Press International - April 09, 2003 Apr 09, 2003 (United Press
International via COMTEX) -- Using state-of-the-art technology, researchers for the first time have measured, to the
split-second, the chemical trigger that makes it difficult for addicts to just say, "No," to drugs, food, sex or other
over-indulgences.

The advance, accomplished by a team of psychologists, neuroscientists and chemists from the University of North Carolina
at Chapel Hill, could pave the way toward novel treatments for habits that exact a heavy price, in health as well
as dollars, investigators told United Press International.

"Our findings are extremely significant because we have identified a dynamic signal in the brain that is highly influential
on drug-taking," said Paul Phillips, research assistant professor of psychology. "Identifying signaling mechanisms
that drive drug-taking provides potential targets for therapeutic intervention."

Due to a lack of standardized classification methods, global addiction statistics are hard to come by, but officials
attest to their epidemic proportions.

For example, the United Nations International Drug Control Program estimates marijuana alone has 141 million users
worldwide. In the United States, a 2001 survey showed some 15.9 million Americans 12 or older partook of illicit drugs.
The Substance Abuse and Mental Health Service Administration blamed the practice for 601,776 hospital emergency department
visits that year.

The U.S. Department of Health and Human Services has implicated drug and alcohol overuse in the death of more than
120,000 Americans each year and in an annual bill totaling more than $294 billion in health care, lost productivity
and other related costs.

In their rat study, detailed in the April 10 issue of the British journal Nature, the scientists offer a much-anticipated
solution to a "chicken-and-egg" puzzle of neurochemical cause and effect in addiction. They identify the key player
as dopamine, the chemical that transports directives from the brain to other parts of the body.

Dopamine is known to increase in levels during addictive behaviors, such as eating, taking drugs or having sex. Experiments
revealed the brain releases the substance before as well as during pleasurable acts. Because the nervous systems of
both rats and humans are similar when stimulated, scientists said they expect the rat results to apply to human research.

In a critical difference from past surveys -- which gave a minute-by-minute account of brain processes underlying
addiction -- the new research presents information about what happens over fractions of a second.

"The problem with previous methods is that they did not provide enough resolution to determine if dopamine release
occurs before drug seeking is triggered," said David Self, associate professor of psychiatry and Lydia Bryant Test
professor at the University of Texas Southwestern Medical Center in Dallas, who analyzed the findings.

"The implications of this study are that split-second dopamine changes are sufficient to influence drug-taking behavior,"
Phillips told UPI.

The high-tech investigation was made possible by a cutting-edge electrochemical technique called fast-scan cyclic
voltammetry, pioneered by Mark Wightman, Kenan professor of chemistry and neuroscience at UT Southwestern.

"Without the advances in his lab and his expertise, this project would have been technically unfeasible," Phillips
emphasized.

Phillips, Wightman, Regina Carelli, Garret Stuber and Michael Heien monitored the release of dopamine over amazingly
brief, 100-millisecond intervals -- about one-third the time the eye takes to blink and some 200 times faster than
has ever been done before.

Working with rats trained to press a lever to receive a cocaine "reward," the team found the chemical trigger both
precedes and proceeds from the pursuit of gratification.

The researchers measured dopamine release in the nucleus accumbens, a brain region implicated in functions ranging
from motivation and reward to feeding and drug addiction. They observed a brief dopamine burst seconds before the animals
approached the lever. In rodents taught to associate a flash of light and a tone with a forthcoming "hit," the audiovisual
cue itself was sufficient to get the dopamine flowing.

"Our work indicates that just the anticipation of receiving cocaine may cause significant increases in dopamine levels
that may control drug-taking behaviors," said Carelli, associate professor of psychology.

The dopamine levels continued to rise as the rodents closed in on the lever and pressed, peaking just after the animals
got their "fix." No such rise in dopamine level was detected in control animals not trained to get cocaine on demand,
Phillips said.

"As a rat chases its tail, drug addicts may suffer a similar vicious circle of priming and reward controlled by these
dopamine signals," Self explained. "Therapies aimed at preventing one or both of these dopamine signals could be effective
treatments for addiction."

The irresistibility of the signals' effect is exemplified by the inability of food addicts to stop with just one
bite, scientists said.

"Chocolate lovers whose cravings are strongly enhanced by tasting just a small morsel often experience this priming
effect," Self told UPI. "The initial taste whets the appetite for more, explaining the brief shelf life of an open
chocolate box."

In suggesting the same chemical that produces euphoria with cocaine also can trigger yearning for the drug, the study
raises the prospect of new treatments, scientists said.

"Pharmacological or behavioral treatments that blunt this dopamine pulse, without completely blocking all dopamine
function, could be one way to prevent drug craving," Self said.

In a study supported by the National Institute on Drug Abuse (NIDA), researchers found that heavy stimulant abuse
can result in changes in attention and motor skills that can persist for at least a year.

The investigators studied 50 pairs of twins; in each pair, one twin had a history of abusing cocaine and/or methamphetamine
and the other had no history of drug abuse. Thirty-one monozygotic (identical) and 19 dizygotic (fraternal) adult
male twin pairs were tested for attention and motor skills, executive functioning, intelligence, and memory at least one
year after the drug-using twin's last-reported use of stimulants.

The researchers, led by Dr. Rosemary Toomey from Massachusetts General Hospital, found that the twin with a history
of stimulant abuse performed significantly worse on several tests of attention and motor skills than did the sibling
who had never used drugs.

However, abusers outperformed their non-drug-using twin on visual vigilance, a test measuring the ability to pay
attention over time.

WHAT IT MEANS: This study provides evidence that stimulant abuse can result in long-term residual neuropsychological
effects.

The study was published in the March 2003 issue of the journal Archives of General Psychiatry.

Alcohol-induced blackouts may lead to heavier drinking21:00 14 April 03NewScientist.com news servicePartial
memory blackouts after drinking binges could contribute tofuture alcoholism, say researchers, because drinkers may fill
in theblanks with rosy memories.

Experiments involving moderate alcohol intake showed that drinkerswho had previously suffered partial memory loss
had poorer memoriesthan drinkers who had not. Questionnaires also revealed that thememory loss drinkers also had more
optimistic attitudes about theeffect alcohol had upon them.

These results, and others from the same study, led the scientists atthe University of Texas in Austin to conclude
that drinkersexperiencing "fragmentary blackouts" are more likely to misrememberdrinking experiences and then fill
in the gaps with positive beliefs.And this would increase the likelihood of them drinking heavily inthe future, the
researchers say.

Psychologist William Corbin, one of the team, notes that unlike totalblackouts, drinkers experiencing fragmentary
blackouts could remembersome things when prompted by cues. He told New Scientist that thesepeople's beliefs about
their lost time are "unrealisticallypositive". For example, they believe alcohol makes them moresociable, sexually
attractive or assertive, he says.

Corbin believes blackouts should be given more weight as an earlywarning sign of future alcohol problems. "It could
identify peoplemore at risk."

Non-alcoholic placebo

The team examined 108 college students who were weekly bingedrinkers. Half had experienced fragmentary blackouts
(FB) in theprevious year, half had not.

When given three alcoholic drinks, FB students showed worse memoryboth during and just after intoxication. However,
there was nodifference when the drinks were non-alcoholic placebos.

"In the absence of alcohol, the memory ability of those who reportfragmentary blackouts does not appear to be any
different from thosewho do not experience these phenomena," says Kim Fromme, apsychologist at the University of Texas.
"Yet when they drinkalcohol, people who experience fragmentary blackouts show poorermemory performance."

Fromme adds: "If you already believe alcohol has primarily positiveeffects, and you cannot recall what happened after
a drinkingepisode, you are likely to assume that the outcome was positive."

"We are very worried about binge drinking," says Anne Jenkins, aspokeswoman for the UK's Alcohol Concern. "There's
an assumption thatthe harmful effects are only immediate, but some studies arebeginning to suggest that regular binge
drinking can have long termhealth effects."

One adult in 13 is dependent on alcohol and 33,000 people die eachyear due to alcohol-related incidents or associated
health problemsaccording to UK government statistics.Journal reference: Alcoholism: Clinical and Experimental Research(vol
27, p 628)

Heroin Use Higher in New Jersey's Suburbs, Rural Areas

Does Data Reflect National Trend?

By Jeanie Davis

WebMD Medical News

May 17, 2001 -- Injection drug use has declined steadily inAmerica'sinner cities, but New Jersey's public health
officials havedetecteda disturbing new trend. Since 1993, the use of injectable heroinandcocaine has increased
-- raising concerns about spread of HIV andother infections.

And the increased use was in young adults outside the urban areas--a group not previously thought to be at high
risk, says the new CDCstudy.

"We found an increase in injection heroin use in younger age groups-- 18 to 25 -- in all ethnic groups across the
state," says leadauthor Anna Kline, PhD, director of research in the division ofaddiction services of the New Jersey
Department of Health. "We alsonoticed an expansion into the suburbs and rural areas."

In her study, Klein looked at data on persons admitted to NewJerseyaddiction outpatient treatment centers who
reported usinginjectabledrugs from 1992 to 1999. She also analyzed data on users ofinjectable heroin and cocaine
from 1980 to the early 1990s. Thenumbers of injectable users declined from the 1980s through theearly1990s, says
Kline.

In 1995 the trend shifted, with 43% of patients reporting use in1993compared with 45% in 1999. The largest increases
were among those18to 25 years old, says Kline. That number rose from 22% in 1993 to46%in 1999.

Total numbers of injectable drug users increased substantiallyamongsuburban/rural residents from 1993 to 1999
while it declined amongurban residents.

"Quite bluntly, that can't be good news," says George DiFerdinando,MD, deputy commissioner for the New Jersey Department
of Health andSenior Services. DiFerdinando is a co-author of the CDC study.

But can local drug use patterns give an idea of what's going onnationally?

"Not really," says DiFerdinando. "To a surprising extent, drug usepatterns can be very local or even regional. Methamphetamine
isextremely popular in other parts of the country, but we haven't hadtoo much of that problem in New Jersey. We have
a substantialproblemwith ecstasy while some parts of country don't."

It's the age group that he's most concerned about, DiFerdinandotells WebMD.

"We see it in this study and others -- high-risk behaviors in the18-to 25-year-old group have greatly increased.
The message isn'tgetting through. We have to keep pushing the prevention messagewiththe same intensity that we
did at the beginning of the HIV epidemic15 years ago. It was a crisis atmosphere, and we felt we had to doeverything
possible."

Not all experts agree with the CDC data. In fact, national studiesshow that since 1995 heroin use in young adults
-- 19- to29-year-olds -- has remained "amazingly constant," says LloydJohnston, PhD, principal investigator of the
Monitoring the Futurestudy from the University of Michigan Institute for SocialResearch.His studies are funded
by grants from the National Institute onDrugAbuse, an arm of the National Institutes of Health.

Johnston has tracked drug use for the past 25 years amongadolescents, college students, and young adults across the
country,Johnston tells WebMD.

"We're quite good at looking at the nation as a whole," saysJohnston. "We don't show any change since 1995 in heroin
use inyoungadults -- 19- to 29-year-olds. But our data is of high schoolgraduates -- some 85% of the population.
The other 15% may be theheavier heroin users. Our absolute estimates are undoubtedly low,butI think we're picking
up the trends. And I don't see any trends ofthat sort."

Another major source -- the National Household Survey on Drug Abuse-- also shows no increase in heroin use among
the 18 to 25 agegroup,says Johnston. "In fact, they show a decrease in that population."

Main message from her study, says Kline: "The need for aredirectionof prevention efforts," she tells WebMD. "We
have been placing alotof preventive dollars for HIV/AIDS into the urban areas and not somuch into the suburbs."

Also, the message needs to target younger kids, says Howard Simon,spokesperson for Partnership for a Drug-Free America.
"If you'retalking about 18- to 25-year-olds, you're not talking about newdrugusers. They've probably been using
for a while. We like to look atthe next group coming up, the 12- to 17-year-olds."

"I've had 13-, 14-, 15-year-old girls with [skin and muscle]infection ... from a dirty needle," Jenkins tells WebMD.
"They haveto have the muscle in their arm removed; they go through hell withthat. We need to get the message to them
better. Kids just haven'tgotten the message about sharing dirty needles. They figure if theyboth use same needle,
then it's a clean needle. It's still a dirtyneedle."

What Do We Want? Rewards! When Do We Want 'Em? Now!

Instant Gratification, Addictive Behaviors May Lie in SpecificBrain Area

By Neil Osterweil

WebMD Medical News

May 25, 2001 -- Good things may come to those who wait, but peoplewho actimpulsively simply can't wait for
their rewards, and settle forwhatever theycan get NOW. A new study suggests that impulsive behavior -- afeature
ofaddictions, attention-deficit hyperactivity disorder, and somepersonalitydisorders, may be caused by a brain
defect.

In the study, reported in the May 25 issue of the journal Science,ratstrained to understand that they can
have one sugar pellet now orfour latersoon catch on to the idea that waiting can bring sweet rewards.

But when the same rats have damage to an area of the brain calledthe nucleusaccumbens, they appear to lose
their ability to make wise choicesand alwaysgo for the quick and easy fix, something like look-before-you-leapbehavior,report
Rudolf Cardinal, PhD, and colleagues in the department ofexperimentalpsychology at the University of Cambridge, England.

A naturally-occurring substance called dopamine may help explainthisphenomenon. Dopamine is one of the chemicals
that allowcommunication betweennerves in the brain. It is also known to be involved in thesensation ofreward
we experience from something we enjoy. Cardinal tells WebMDit's beenknown for a long time that natural rewards, like
food and sex, aswell asartificial ones, like nicotine and cocaine, act on dopamine toactivate thenucleus accumbens.

The conclusion that the nucleus accumbens is at the center of ourrewardsystem is bolstered by a second study
published in the May issue ofthejournal Neuron. In it, researchers report that the regions of thebrain --including
the nucleus accumbens -- that become activated in theanticipationand experience of winning at gambling, in a sense
another type ofaddictive,impulsive behavior, are the same regions that appear to respond incocaineaddicts.

Hans Breiter, PhD, co-director of the Motivation and EmotionNeuroscienceCenter in the department of radiology
at Massachusetts GeneralHospital, andcolleagues used a high-power, real-time brain imager to look atbrainactivity
in 12 men taking part in a computer-controlled game ofchance.

The subjects were given a $50 stake and were told that they couldlose someor all of it, keep it, or increase
it. The volunteers were firstshown howmuch they could win by watching where the spinner landed on awheel-of-fortune;
this part of the test was called the expectancyphase. Inthe second or "outcome" phase, participants found whether
they hadactuallylost or won.

The researchers found that as the prospect of winning more moneyincreased,so did activity in the parts of
the brain previously seen torespond to othertypes of rewards, such as drugs. The level of activity in thenucleusaccumbens
and two other nearby regions grew as the potentialjackpotincreased in the expectancy phase, and similar changes were
seenduring theoutcome phase.

A researcher who has studied the genetics of addictive behaviorstells WebMDthat certain people have genetic
abnormalities in their rewardsystems. Thenucleus accumbens, he says, sits at the center of the reward systemwhen
it'sstimulated by gambling. Defects in this system, "can lead not onlytopotential problems with addictive behaviors
but with impulsivity ingeneral,"like that which occurs in attention-deficit hyperactivity disorder,saysDavid
Comings, MD, director of medical genetics at City of HopeMedicalCenter in Duarte, Calif.

Comings points out that the drug Zyban, which is sometimesprescribed to helppeople quit smoking, is an antidepressant
that acts on dopamine inthe brain,and that Ritalin, widely prescribed for children with ADHD, alsoacts tonormalize
dopamine levels. These observations are suggestive of anunderlyingdefect common to addiction, ADHD and other forms
of impulsivebehavior.

CHOLECYSTOKININ PEPTIDE FRAGMENT TREATS ALCOHOLISM IN RATSInjecting rats with a four-amino acid peptide restores
thecholecystokinine system in the frontal cerebral cortex andhypothalamusafter it has been deregulated by chronic
alcohol consumption,Russianresearchers have shown.

LONDON (Reuters) - Cocaine addicts may have such a tough timekickingthe habit because cravings for the drug increase
long after theyhavestopped taking it, scientists said Wednesday.

Instead of gradually diminishing with time, an animal studyshowedthat longings for the popular recreational drug
get worse withtimeand increase the likelihood of a relapse.

The findings by scientists at the National Institute on DrugAbuse(NIDA) in the United States could offer new
insights into how tohelpaddicts who have repeatedly tried but failed to give up cocaine.

``This phenomenon helps explain why addiction is a chronic,relapsingdisease,'' Dr. Alan Leshner, the director
of the NIDA, said in astatement.

``Craving is a powerful force for cocaine addicts to resist, andthefinding that it persists long after last drug
use must beconsideredin tailoring treatment programs,'' he added.

NIDA scientists studied the impact of cocaine withdrawal andrelapseon rats over periods ranging from a few days
to two months.

They noticed the first evidence of craving in the animals afterabouta week without the drug. The longings grew
over time and were thestrongest at two months, the maximum length of the study.

Dr. Jeff Grimm, an experimental psychologist who led the researchteam, and his colleagues said that although the
research waslimitedto rats, it has implications for human addiction.

``If you look at relapse rates over time you tend to see thataddictsrelapse even after years of abstinence so
something is persistingthat is calling people back to the drug after time,'' he said inatelephone interview.

``What we are seeing with the rats is that instead of immediatelyfollowing the cessation of the drug the cravings
become strongerovertime.''

The scientists said they know the underlying mechanism whichcausesthe cravings but they suspect changes in the
brain over timecouldcontribute to the phenomenon.

Grimm said the cravings in the rats were also linked todrug-associated environmental cues, similar to what has beenshown
indrug addicts.

In the experiments the scientists trained the rats to press aleverto receive intravenous cocaine injections.
Afterward they testedtheanimals to determine if they would press the lever even if theynolonger received the
cocaine.

Their research is published in the science journal Nature.

Drug addicts also have environmental cues, such as the sight of asyringe or other paraphernalia, that they associate
with the drugandwhich could trigger a relapse.

Drug Treatment Programs Can Work for Teens

By Suzanne Rostler

NEW YORK (Reuters Health) - Drug treatment programs designed tomeetthe specific needs of adolescents can reduce
rates of drug useandcrime and improve academic performance among this group, resultsof astudy report.

According to Dr. Christine E. Grella, a study author, these typesofprograms are relatively new. Prior to the
late 1980s, she said,youngdrug abusers were treated with adults.

``Adolescents entering drug programs have very different issuesthanadults,'' said Grella, an associate research
psychologist at theUniversity of California in Los Angeles.

For example, younger drug abusers are more likely to usemarijuanaand alcohol while adults are more likely to
use cocaine andhallucinogenics, she said. Adolescents have developmental issuesasthey attempt to separate from
their families, she added, and theymaybe dealing with mental health disorders or physical and sexualabuseat
home.

Indeed, the study in the July issue of the Archives of GeneralPsychiatry reports that about 63% suffered from mental
disorderssuchas depression or attention deficit hyperactivity disorder, andabout58% had legal problems.

``If they only get drug counseling and don't get their otherneedsmet, they are more likely to return to treatment,''
Grella toldReuters Health.

The study included more than 1,100 adolescents aged 11-18 years,whowere enrolled in 23 treatment programs in
four US cities.Accordingto results, nearly 44% reported using marijuana weekly one yearaftertreatment, compared
with more than 80% at the outset. Similarly,about 20% reported drinking heavily a year later, versus morethan34%
initially.

However, patients who used hallucinogenic drugs and stimulantssuchas cocaine were less likely to improve.

The study also found that success was more likely to occur whentreatment lasted longer, regardless of the severity
of theproblem orthe type of program. Individuals who remained in treatment longerwere less likely to use drugs
or get arrested, for instance.

According to the study, the findings highlight ways in whichtreatments programs can be improved and underscore the
importanceofaddressing other problems. However, there are not enoughtreatmentprograms to meet the needs of
adolescents, Grella said.

In the study, treatment programs included residential programs inwhich patients lived at the facility and attended
counselingsessions, outpatient programs in which adolescents attendedintensiveday treatment, and short-term inpatient
programs that providedcounseling sessions and lasted up to 35 days.

SOURCE: Archives of General Psychiatry 2001; 58: 689-695.

Drug Use Rises Among High School StudentsFather-Only Households Least Likely to Keep Kids Off DrugsBy Sean
MartinWebMD Medical NewsJuly 19, 2001 (Washington) -- Drug use is on the rise among highschool students after
several years of declining use, accordingtonew results from an annual survey used to help guide the nation'sdrug
control policies.

According to the Pride survey, high school students (grades 9-12)reported higher use of marijuana, uppers, downers,
hallucinogens,andheroin compared with last year's study.

Doug Hall, spokesman for Pride, says, "We are finding a reallytoughnut to crack among the older students."

Meanwhile, among junior high students, drug use appeared to climbslightly, but the results were not "statistically
significant."

According to the new survey, 22.5% of high schoolers said theyusedat least one illicit drug on a monthly basis,
while 35.3% used adrugat least once in the 2000-01 school year. By contrast, in the1999-2000 year, 21.3% reported
monthly use, and 34.3% reportedyearlyuse.

The drug increase marked the survey's first discovered "reversalagainst progress" since the 1996-97 school year.

The results may steer federal policymakers to step up their drugprevention efforts with older teens.

The White House's Office of National Drug Control Policy saysthat ithas primarily targeted students aged 11-13
in its anti-drug mediacampaigns. But Arthur Dean, chairman of Community Anti-DrugCoalitions of America, says, "We
need to expand upon these mediaandeducation programs and do a better job curbing drug use amonghighschool
students."

Thomas Gleaton, founder of the Pride survey, also says theresultspoint to the possible need for increased efforts
to target olderteens in antidrug campaigns.

The Pride survey was conducted during the recently concludedschoolyear and involved nearly 76,000 students in
grades 6 through 12.Itis the largest independent measure of youth drug use.

The survey also found that students living only with their fatherwere more likely to use drugs than those youth in
any otherfamilyconfiguration. By contrast, those students who lived with both oftheir parents were the least likely
to report any use of illicitdrugs.

Meanwhile, the survey brought some good news. Student use ofalcoholand cigarettes dropped to its lowest level
in more than 10 years,itsaid. Some 52.1% of students in grades 6 through 12 said thattheyhad used alcohol
within the last year, which was the smallestpercentage since 52.0% reported this pattern of use in 1987-88.

For cigarettes, the survey found that annual use was 30.5% amongthose in grades 6 through 12; in 1987-88, 29.1% of
students hadreported smoking.

The survey also found the following:Compared with last year, slightly fewer kids said their parentstalked with
them frequently about the risks of alcohol and drugs.Children whose parents never talked to them about illicit drugswerefar
more likely to use these substances than kids whose parentsspokewith them "a lot" about the problem. Students with
clear rulesaboutfamily standards were much less likely to report use of illegaldrugs. Children who often attended
religious services were lesslikely to report illicit drug use.

These results, says Edward Jurith, the White House acting drugczar,"confirm the importance of parental involvement
in children'slivesas one of the key factors in keeping kids off drugs."

Jurith says, "Youth with strong parental influences and access tolocal support networks are much less likely to use
illegaldrugs."

Carl Pickhardt, PhD, author of Keys to Raising a Drug-Free Child,tells WebMD, "what parents want to do is keep their
kid asanchoredas possible in activities and relationships that they really careabout."

More Kids Living With GrandparentsBy GENARO C. ARMAS, Associated Press WriterWASHINGTON (AP) - It's no longer
just a place to visit onweekendsand holidays - for more American children, Grandma and Grandpa'shouse is home.

The number of kids under age 18 living in a grandparent-headedhomeincreased in nearly every state for which the
latest round of2000census data is available. Figures released Wednesday for Florida,forinstance, showed 258,952
kids living in such homes, a 33 percentrisesince 1990.

The trend is reminiscent of the pre-World War II years, whenthree-generation households were not uncommon, said GregoryBrock,director
of the University of Kentucky Family Center.

But the findings also come at a point when the issue ofvisitationand custody rights for grandparents has become
a sensitive one incourts and legislatures across the country.

And for grandparents raising kids without one of the grandchild'sparents living with them, it has become an unexpected
financialburden that lawmakers must ease with more financial assistance,saidAmy Goyer, a program coordinator for
AARP. AARP is the country'slargest advocacy group for senior citizens.

Jim and Toni Landenberger, of Naples, Fla., were awarded custodyoftheir two grandsons after their daughter -
the boys' mother - wassent to prison and the boys' father died. A lengthy custody fightwith the father's family drained
their savings.

The Landenbergers say they are happy and that the fight for theirgrandsons was worth it. But money concerns weigh
on their mind.

``It's nothing you really planned for, because there is no suchthingas retirement now,'' Mrs. Landenberger said.
``You are doingthingsaround school that you hadn't planned on doing.''

The figures offer another perspective into the more diversemakeup ofthe American family highlighted by the 2000
census.

In Florida, for instance, the percentage of children under 18livingin a grandparent-headed home rose from 6.8
percent in 1990 to 7.1percent in 2000.

Children living in married-parent homes still represented themajority in Florida - 2.2 million, or 61.3 percent of
all kidstherein 2000. But that share was down from 65.8 percent a decade ago.

Data also released Wednesday for Hawaii showed that 12.9 percentofchildren there lived in a grandparent's home
in 2000, up from10.4percent in 1990.

Meanwhile, 61.9 percent of Hawaiian kids lived in married-parenthomes in 2000, down from 69.4 percent in 1990.

``Society in general is beginning to understand more aboutgrandparents raising grandchildren,'' said Kathy Reynolds,
ofEnfield, Conn. After her daughter went into drug rehab, Reynoldsgained custody of her 5-year-old granddaughter.

A 1997 Census Bureau (news - web sites) survey estimated thatmorethan half the kids living in grandparent-headed
homes had theirmother living in the house with them. About one-third of thehomesdid not include one of the grandchild's
parents.

National numbers from the 2000 census will not be available untilafter all 50 states get their data, expected by
mid-August.

Additionally, these figures do not show, for instance, the numberofgrandparents living in a home headed by their
own son or daughterandplay a caregiving role for grandchildren. That kind ofinformation isexpected to be released
next year.

The 1990 census found 3.5 million children under age 18 in theUnitedStates, or 5.5 percent of kids, living in
a grandparent-headedhome,up from 3.2 percent of kids in 1970.

While previous studies have shown that grandparent-headedhouseholdsoccur more in low-income families, divorce,
career choices andjobconstraints are causing the numbers to rise in all socio-economicgroups, Brock said.

An increase in drug abuse in recent decades has also contributedtothe trend as addicted parents suffer health
problems, enterrehabilitation programs, or are jailed, he said.

Embalmed Cigarettes Gain PopularityBy JOANN LOVIGLIO, Associated Press WriterPHILADELPHIA (AP) - Embalming
fluid is becoming an increasinglypopular drug for users looking for a new and different high - onethat often comes
with violent and psychotic side effects.

Users - mainly teen-agers and people in their 20s - are buyingtobacco or marijuana cigarettes that have been soaked
in thefluid,then dried. They cost about $20 apiece and are called by nearly adozen names nationwide, including
``wet,'' ``fry'' and ``illy.''

``The idea of embalming fluid appeals to people's morbidcuriosityabout death,'' said Dr. Julie Holland of New
York UniversitySchoolof Medicine. ``There's a certain gothic appeal to it.''

Formaldehyde can be bought in drug stores and beauty supplystores.(It is an ingredient in nail care products).
It is also availableinmany school science labs. In addition, there have been reports ofembalming fluid thefts
from funeral homes in Louisiana and NewYork.

Although there are no national statistics on usage, many drugexpertssay it appears to have spread from the inner
cities to well-to-dosuburban neighborhoods and college campuses.

``Whether they live in a million-dollar house or a $5,000 house,kidswho are smoking pot or crack and are looking
for a different typeofhigh are turning to wet,'' said Julie Kirlin, a juvenileprobationofficer in Reading,
about 50 miles from Philadelphia.

Embalming fluid is a compound of formaldehyde, methanol, ethanolandother solvents. The high depends on what the
user is reallygetting:Often the drug PCP is mixed in. In fact, PCP has gone by thestreetname ``embalming fluid''
since the 1970s.

Twenty Houston-area users interviewed for a 1998 study by theTexasCommission on Drug Abuse said the effects include
visual andauditoryhallucinations, euphoria, a feeling of invincibility, increasedpaintolerance, anger, forgetfulness
and paranoia. Stranger symptomsreported include an overwhelming desire to disrobe and a strongdistaste for meat.

Other symptoms may include coma, seizures, kidney failure andstroke.The high lasts from six hours to three days.

``Fry users are described like those who do a lot of inhalants -they're just spaced-out, dissociative,'' said Jane
Maxwell of theNational Institute on Drug Abuse's Community Epidemiology WorkGroup.When they've taken PCP, ``they
come into the emergency room andarejust wild. They have to be strapped down in their beds or theydestroy the room.''

In the Philadelphia suburb of Doylestown, a 14-year-old boyfatallystabbed a 33-year-old neighbor more than 70
times last year aftersmoking wet. The boy, who said he took wet to quiet the voices inhishead, is serving a seven-year
sentence.

``This is a violent drug, and it will turn into a big fire ifit'snot watched very closely,'' Kirlin said.--

'Intense' Psychiatric Care May Not Cut Violence

Updated: Fri, Nov 09 1:51 PM EST

By Amy Norton

NEW YORK (Reuters Health) - "Intensifying" outpatient treatment formentally ill patients at high risk for violence
does not appear tomake a dent in their violent tendencies, UK researchers report.

Their study findings suggest that whole new strategies to tackleproblems such as substance abuse and poor adherence
to medication areneeded.

In the study, about 700 people with psychotic illness receivedoutpatient care coordinated by case managers--health
professionalswho meet with patients regularly and help organize the variousaspects of an individual's care. Those
in the intensive-managementgroup met with case managers twice as often as patients understandard care did, the report
indicates.

But after 2 years, the rates of violent acts were nearly identical inthe two groups. Twenty-three percent of patients
in the intensivegroup and 22% in the standard group committed assault during thestudy period, according to findings
published in the November 10thissue of the British Medical Journal.

Younger patients, those who had been victimized themselves and thosewho abused drugs were among the patients most
likely to commitviolent acts.

"What (this study) might suggest is that psychotic patients with apropensity for violence or with risk factors for
violence--forexample, substance misuse--may require a specific range ofinterventions," the study's lead author, Dr.
Elizabeth Walsh of theInstitute of Psychiatry in London, told Reuters Health.

Such interventions would include substance abuse treatment andefforts to make patients comply with their medication,
according toWalsh.

She noted that in the US, many states have "involuntary outpatientcommitment," in which certain patients are legally
required to stickwith their outpatient psychiatric care. One study, Walsh's teamreports, has suggested that when coupled
with routine care, "enforcedcommunity treatment" reduces violent acts among patients at high riskfor violence.

In an editorial published with the report, Dr. Tilman Steinert writesthat "actually, a rather effective treatment
for violence inseriously mentally ill people is available, but only for limitedperiods: hospital treatment."

Factors in violence such as drug use, noncompliance with medicationand "criminal peers" are minimized when patients
are in hospitals,notes Steinert, of the Centre of Psychiatry at the University of Ulmin Germany.

Walsh, too, said that for some mentally ill patients, hospitalizationmay be needed.

"On some occasions," she said, "it is necessary for patients to bedetained for their own safety and the safety of
others." However,Walsh added, it is wrong to "lock people up and throw away the key"rather than search for other strategies
to help them.

Steinert agrees that other treatment options must be explored,writing that "further research should address the question
of whetherforms of compulsory outpatient treatment combined with psychosocialsupport can be developed."SOURCE:
British Medical Journal 2001;323:1080-1081, 1093-1096.

Alcoholism: Clinical & Experimental ResearchHow 'negative emotionality' can make you feel sick"Negative
emotionality" (NE) reflects a tendency toward depression,anxiety, and poor reaction to stress. Prior studies have shown
thatadolescents with alcohol use disorders (AUDs) self report more healthproblems than 'normal' adolescents do. A
new study has found thatadolescents with AUDs self report many more health problems thansupported by laboratory and
physical exam findings. These reportedhealth problems seem to be predominantly of psychological origin orNE.

"Negative emotionality" (NE) is the antithesis of positive thinking.NE refers to a propensity toward depression and
anxiety, and atendency to react to stressful situations with unpleasant emotions. Astudy in the September issue of
Alcoholism:Clinical & Experimental Research examines the relevance of NE tohealth problems self reported by adolescents
with alcohol usedisorders.

"Everyone has a degree of negative emotionality," said Duncan B.Clark, a psychiatrist, psychologist, director of
the PittsburghAdolescent Alcohol Research Center, and lead author of the study."This is not a disorder or a categorical
trait; it is the degree towhich an individual reports certain emotional characteristics."

Prior studies had shown that adolescents with alcohol use disorders(AUDs) tend to self report more health problems
than 'normal'adolescents do. Self-reported health problems may also be consideredhealth complaints. Information about
the origin of theseproblems/complaints was less forthcoming, which prompted Clark andhis colleagues to undertake their
study.

"There are four likely explanations," said Clark. "One, thesesymptoms may be due to biomedical problems caused by
alcohol. Two,they're related to cigarette smoking, also common in this group.Three, the complaints may be related
to anxiety and depression, andmay therefore be considered 'psychosomatic.' Four, adolescents withalcohol use disorders
have relatively poor health maintenance and,therefore, more health problems as a result. We found evidence thatall
four of these mechanisms are operating."

Study participants (the average age was 16 years) were asked to selfreport health symptoms from 136 possibilities
in 15 areas (such assleep, heart and lungs, and neurology), have three serum liver enzymelevels measured, submit to
physical examinations by a medicalprofessional, and have their NE measured via questionnaires and aninterview. Certain
connections were immediately apparent among thegroup with AUDs. Symptoms linked to heart and lungs, such asshortness
of breath, were correlated with smoking. The liver enzymeelevation, albeit modest, demonstrated a risk for liver injury.Abnormal
oral exam results reflected poor health maintenance.However, said Clark, whereas laboratory and physical exam findingswere
relatively normal, self reported health problems or healthcomplaints were highly elevated.

"Most of the complaint areas were highly correlated with negativeemotionality," he said, "our index of anxiety and
depression. Theapparently small degree of organ disease or damage evident in thelaboratory results and physical exams
suggests that the healthproblems were predominantly of psychological origin. However, I wouldnot go so far as to say
these health problems were 'all in theirhead.' Anxiety and depression have been shown to cause demonstrablephysical
changes."

Alcohol use and associated problems typically begin during theteenage years, and often rise dramatically. In 1999,
according to the10th Special Report to the U.S. Congress on Alcohol and Health, 52percent of 8th graders (14-year-olds)
and 80 percent of 12th graders(18-year-olds) reported having used alcohol at least once. Researchindicates that rates
of AUDs also rise dramatically duringadolescence, and are nearly as high as those of adults by the end ofthis period
(18 years of age).

"Adolescents' alcohol involvement is occurring during a period oftime when their bodies are still developing," said
Sandra A. Brown,chief of psychology at the VA San Diego Healthcare System andprofessor of psychology and psychiatry
at the University ofCalifornia, San Diego. "Early and protracted alcohol use by teens canhave both short and long
term health effects. For example, in ourstudies of youth evaluated over a six-year period, we found thatrespiratory,
and accident and trauma injuries, were particularly moreprevalent among youth with alcohol use disorders than among youthwith
similar backgrounds but without alcohol use disorders. We'vealso found that health problems are more severe the longer
that heavyalcohol use goes on during adolescence, and that girls report moreadverse effects than boys. Clearly," she
added, "alcohol usedisorders during both adolescence and adulthood have importantramifications for an individual's
medical health, mental health, andcognitive functioning."

"What this study highlights," said Brown, "is that negative emotionsand alcohol use disorders go hand in hand. What
remains to sort outis when those negative emotions are substance/alcohol induced, asthey can be in adults, and when
they are a factor that could leadsomeone to use alcohol, and consequently, have the health problemsthat were examined
in the Clark study."

Co-authors of the Alcoholism: Clinical & Experimental Research paperincluded: Kevin G. Lynch and John E. Donovan
of the PittsburghAdolescent Alcohol Research Center; and Geoffrey D. Block of theDepartment of Surgery at the University
of Pittsburgh School ofMedicine.

PHILADELPHIA, Sep 4, 2001 /PRNewswire via COMTEX/ -- Mice devoid of a singlebrain receptor, mGluR5, appear free
from the psychostimulant and thereinforcing effects of acute and repeated administration of cocaine, it isreported
in the September issue of Nature Neuroscience.

The findings point toward a novel understanding of the biological processesunderlying drug dependence. It has been
known that following chronicadministration of cocaine, the expression of mGluR5 (metabotropic glutamatereceptor subtype
5) is increased in a region of the brain (the nucleusaccumbens) within the brain's "natural reward circuit". The currentlyreported
study, in which the mice were rendered devoid of mGluR5 by geneticmutation, now provides compelling evidence of the functional
role of thisreceptor in the behavioural effects of cocaine.

The report is based on work by GlaxoSmithKline (NYSE: GSK) researchers at theCentre of Excellence for Drug Discovery,
Psychiatry, in Verona, Italy, and atthe GSK Experimental Pathology Department at the Institute of CellularBiology
and Morphology in the University of Lausanne, Switzerland. Alsocontributing were scientists at the Neuromed Institute
in Pozzilli, Italy, aninstitute for scientific and clinical research associated with the Universityof Rome La Sapienza.

"Although we have yet to elucidate the exact nature of the mGluR5contribution to cocaine dependence, regardless of
the specific mechanisminvolved, these results suggest that mGluR5 is essential to that dependence,"said Dr Francois
Conquet, an author of the paper and the leader of theresearch team in Lausanne.

Glutamate, the neurotransmitter that binds to the mGluR5 receptor, is theprincipal excitatory neurotransmitter in
the mammalian brain. It exertsvarious actions by means of multiple receptor proteins. Historically,however, the psychostimulant
and reinforcing effects characteristicallyinduced by cocaine have been thought to be more closely associated with adifferent
neurotransmitter, dopamine. Cocaine is known to block dopamine re-uptake in nerve cells, increasing the level of extracellular
dopamine. It haslong been suggested that this increase in dopamine levels is the primarycause of the behavioural effects
of cocaine.

Yet in the report in Nature Neuroscience, Dr. Conquet said, "We show that,although dopamine levels are still increased
by cocaine, the reinforcing andstimulant effects appear to be mediated by glutamate through mGluR5 while thespecific
role of dopamine is not clear."

Functional examination of the different mGluR5 subtypes allowed researchersto compare responses of mGluR5-gene-mutated
mice and normal, or wild-type,littermates to experimenter-administered cocaine or in cocaineself-administration models
designed to investigate the reinforcing propertiesof cocaine.

The mutant mice displayed none of the characteristic stimulant effects ofcocaine administration, such as hyperactivity.
"Locomotor activity wasunaffected," said Dr. Conquet, "despite cocaine-induced increases in nucleusaccumbens dopamine
levels similar to those in wild-type mice." In the cocaineself-administration model, which allows mice to press a lever
for a cocainedose, the mutant mice didn't self-administer at any of the doses tested,though they did learn to press
a lever to receive food.

Moreover, in normal mice, administering a drug that temporarily blockedmGluR5 function led to decreased cocaine self-administration.

The team conducted additional studies showing that both brain distributionand expression of dopamine receptors and
dopamine transporter were notaltered following mGluR5 mutation-further evidence that the responses tococaine seen
in mutant mice were not due to any mGluR5-mutation-inducedalterations in dopamine activity.

"This biological understanding offers our research centre a significantopportunity for further research intended
to discover new therapies for drugdependence," said Dr. Emiliangelo Ratti, Senior Vice President at the GSKcentre
in Verona. "If these results can be expanded to other drugs of abuse,medicines acting on this target could be of benefit
in the clinical treatmentof drug dependence, a disease with large unmet medical needs and widespreadsocial impact."

Study: Drug Use Declining Among College StudentsBy Charnicia E. HugginsNEW YORK (Reuters Health) - Gone are
the days when college studentscould say ``everybody's doing it''--with the ``it'' referring to druguse, new study
findings suggest.

Drug use during the college years seems to be declining, researchersreport. And drug users are exhibiting distinctly
different lifestylebehaviors and values from those of their non-drug-using peers.

``It appears that drug use is becoming a little less 'mainstream' anda little more 'deviant' on the campus than it
was one or two decadesago,'' study lead author Dr. Harrison G. Pope, Jr., of HarvardMedical School in Massachusetts,
told Reuters Health.

Pope and his colleagues performed a 30-year study of various groupsof senior undergraduate students at a college
in New England. Thestudents completed questionnaires in 1969, 1978, 1989 and 1999.

Findings show that the students' use of cocaine, LSD, opium and otherdrugs peaked in 1978 and declined in subsequent
years, theinvestigators report in the September issue of the American Journalof Psychiatry. The one exception was
the increasing use of MDMA(Ecstasy) in later years, which subsequently made the drug one of themost frequently tried
illicit substances, second only to marijuana,the authors note.

Differences between drug users and non-drug users also became moreapparent in later years, the report indicates.

Previously, such differences were limited to a greater number ofpsychiatrist visits and higher levels of heterosexual
activity amongusers than non-users, and both of these factors remained significantin 1999, findings show.

Nearly one quarter of college drug users reported having visited thepsychiatrist, compared with 15% of students who
did not use drugs.More than three quarters of college drug users reported sexualactivity, compared with less than
half (43%) of non-drug users, thereport indicates.

However, 1999 data also revealed that college drug users had worsegrades than their non-drug-using peers and that
they spent less timeparticipating in extracurricular activities. College drug users werealso more likely to report
homosexual activity than non-drug users.

Pope's findings conflict with national data, which shows that druguse during the college years may actually be increasing,
according toSusan Foster of the National Center on Addiction and Substance Abuseat Columbia University in New York.
Foster was not involved withPope's research.

While it is a ``very interesting piece of research,'' she toldReuters Health, it is equivalent to a case study because
it involvedstudents from only one institution. Because of this, ``(one) can'tdraw national conclusions,'' she said.SOURCE:
American Journal of Psychiatry 2001;158:1519-1521.

Marijuana Abuse May Up Risk of DepressionBy Suzanne RostlerNEW YORK (Reuters Health) - Adults who abuse marijuana
may be puttingthemselves at risk for depression, results of a new study indicate.

According to the report, adults who were not depressed when the studybegan but who abused marijuana were about four
times more likely toreport symptoms of depression 15 years later, compared with theirnon-smoking peers.

These adults were especially likely to have had suicidal thoughts andreport a lack of interest in things that once
held their interest,Dr. Gregory B. Bovasso reports in the December issue of the AmericanJournal of Psychiatry. Pot
smokers were four times more likely thantheir non-smoking peers to have suicidal thoughts, and white womenwere found
to be at particular risk.

In the study, marijuana abuse was defined by various signs of problempot use, such as impaired work performance or
using the drug on thejob.

Individuals who used other drugs such as amphetamines and opioidswere about 8 to 10 times more likely to be abusing
pot 15 yearslater. However, those who were depressed when the study began were nomore likely to abuse marijuana later
on, according to the report,which followed nearly 850 adults who were not depressed and more than1,800 who did not
report marijuana abuse at the study's start.

In an interview with Reuters Health, Bovasso suggested that futurestudies investigate how excessive pot-smoking leads
to a higher riskof depression, examine why adults abuse marijuana and establish howmuch pot is enough to put people
at risk of becoming depressed.

In the meantime, the findings ``underscore the importance of cannabisabuse prevention rather than treatment,'' because
they highlight newcases of depression arising among marijuana abusers, the reportconcludes.

``Treatments or other interventions that prevent the abuse ofcannabis from occurring in the first place are important,''
Bovassosaid. ``On a general policy level, marijuana...may not be as harmlessas many believe.''

SOURCE: American Journal of Psychiatry 2001;158:2033-2037.

Some Drug Abusers Wait 10 Years to Seek Treatment

By Charnicia E. Huggins

NEW YORK (Reuters Health) - The vast majority of drug users andabusers are not receiving substance abuse treatment,
past researchhas shown. Now, study results show that many people with substanceabuse problems do seek treatment at
some point in their lives, butthey often wait 10 or more years to do so.

``Prevention is wonderful, but among the people who don't 'just sayno,' we need more opportunities for early help
for those who haveclinically significant problems,'' lead study author Dr. Ronald C.Kessler of Harvard Medical School
(news - web sites) in Boston,Massachusetts, told Reuters Health.

His study's findings are based on surveys of roughly 3,500 adultsfrom Canada, Mexico and the United States who at
some point in theirlives had symptoms that satisfied the criteria for substance abuse ordependence.

Overall, 1,230 survey respondents said that they were seekingtreatment for their disorder, according to the report
in the Novemberissue of Archives of General Psychiatry.

The average length of time that passed between the onset of theirdependence symptoms and their seeking treatment,
however, was 10years or more, with some individuals in the United States taking morethan 16 years.

This long wait may be partly caused by embarrassment or otherpsychological barriers or by legal barriers--for example,
the ideathat if you seek treatment, you are admitting that you're breakingthe law, Kessler said.

On the other hand, ``whether this long lag time should be a source ofconcern is questionable since much of this time
might be spent withonly one or two symptoms of abuse that do not warrant treatment,''Kessler's team writes.

Individuals who reported using more drugs than they intended or usingdrugs for longer periods than they intended,
as well as those who hadtried unsuccessfully to cut down on their drug use, were more likelyto report seeking treatment,
the report indicates. People who hadgone through withdrawal in the past were also more likely to seektreatment.

Also, survey respondents who reported using cocaine and heroin weremore than twice as likely to seek treatment as
those who did not.

``One plausible interpretation of these results is that cocaine andheroin are more likely than other substances to
lead to impairmentsor symptoms that promote treatment seeking,'' the authors note.

In other findings, people whose substance abuse or dependence startedwhen they were 30 or older were more likely
to seek treatment thanthose who had started using drugs earlier.

``The earlier substance disorder starts the less likely you are toget treatment,'' Kessler said. Drug use or abuse,
when begun at ayoung age, becomes a part of the user's life, but when begun later,it is more of a disruption of life,
he explained. ``The trick isearly intervention.''

SOURCE: Archives of General Psychiatry 2001;58:1065-1071.Marijuana's Effects: More Than MunchiesJanuary 29, 2002By
LINDA CARROLL - - NY TimesDawn was 12 when she started smoking marijuana with herfriends. It was just something the
cool kids did to relaxand forget their problems, she says.

But, after a while, the cigar-shaped "blunts" she smokedalso seemed to make learning difficult. "I would justforget
school stuff," said Dawn, now 17. "I'd learnsomething one day and the next day I'd have no idea whatthe teacher was
talking about."

At first Dawn, a Long Islander, limited her marijuanasmoking to the weekends, but soon it became an everydayhabit
that ultimately landed her in a residential treatmentprogram run by Phoenix House.

The debate over whether marijuana is harmful andhabit-forming, as Dawn found, or a fairly benignintoxicant, is
an old one.

And until recently little research had been done to settlethe controversy. For several decades, research on marijuanalagged
that for other illicit substances as scientistsfocused on the drugs like cocaine and heroin with moreobvious addictive
qualities and more drastic and direeffects on users.

But in the past decade, and in particular over the lastyear or so, interest in cannabis has surged, driven in partby
the debate over medical marijuana use for pain relief,nausea and loss of appetite by people with AIDS, cancer andother
debilitating diseases. In addition, experts areintrigued by the discovery of molecules that naturallyoccur in the
body, known as endogenous cannabinoids, orendocannabinoids, which are remarkably similar to theactive ingredient in
marijuana.

Researchers have discovered that receptors for theendocannabinoids are sprinkled liberally throughout thebody
and the brain, suggesting that they play importantroles in regulating a variety of processes.

Recent research into the ways that cannabinoids regulateappetite, pain and memory may not only shed light on theabundance
of sensations experienced by marijuana users -the mellow, the munchies and the fuzzy memory - but mayhelp scientists
develop new, more directed medications tohelp control appetite, ease pain and improve memory.

Scientists have also learned that the drug, which anestimated 70 million Americans have at least tried, may behighly
addictive to a small percentage of those who use it.

Marijuana smokers report a diverse collection ofsensations, and researchers now suspect that is because thedrug's
main active ingredient -delta-9-trans-tetrahydrocannabinol, or THC - is so similarin shape to the endocannabinoids,
which are involved inmany body and brain functions.

Dr. Rachel Wilson, a researcher at Caltech, discovered whenshe was at the University of California at San Franciscothat
endocannabinoids played an important role in thehippocampus, a part of the brain involved in learning andmemory, according
to a report published this spring inNature.

No one has figured out exactly how endocannabinoids areused in the hippocampus, but based on the abundance ofcannabinoid
receptors in this part of the brain and on theexperiences of marijuana users, Dr. Wilson suspects thatthese molecules
help lay down new memories by strengtheningthe connections between nerve cells.

But when the brain is flooded with cannabinoids throughmarijuana use, forgetfulness results, Dr. Wilson said. Itis
probably a case of too much of a good thing, she added.When cannabinoids are abundant, every experience becomesstrongly
linked in our minds, she believes. But wheneverything is marked for memory, the system is overwhelmedand nothing is
remembered.

Dr. Wilson and others also reported last year on anotherimportant role played by cannabinoids. They appear to tonedown
the production of certain neurotransmitters, actinglike the brakes of a car when the system is racing toofast.

Another study published this last year in Nature mayexplain why marijuana users get a case of the munchies. Aninternational
group of researchers found that mice thatwere genetically engineered to be deficient in cannabinoidreceptors ate 40
percent less than normal mice. And in aseparate experiment, the researchers showed that aninterplay existed between
the cannabinoids and leptin, ahormone that produces satiety.

In the study, obese rats that were genetically modified tohave low levels of leptin produced higher amounts ofendocannabinoids.
When the rats were given leptin, theendocannabinoid levels dropped.

Yet another study on cannabinoids published last year mayexplain why marijuana makes people feel good. According
tothe study published in Science, cannabinoids, through acomplex chain of events, rev up the dopamine system.

Like other addictive substances, marijuana appears tohijack brain circuitry that evolved to help people findtheir
way back to a food source or sexual partner. Normallythe neurotransmitters and receptors "are doing a long, slowdance,"
Dr. Wilson said. "Drugs of abuse crash the partyand bring the booze."

Perhaps the most contentious issue has been the question ofwhether marijuana could be addictive. For the manyAmericans
whose experience with marijuana was pleasant andbrief, it may be hard to believe that the drug can bestrongly addictive.

But scientists focusing on cannabis have come up with acomplicated picture. While a majority of people seem to beable
to quit, there appears to be a small segment of thepopulation - some 10 to 14 percent - that can becomestrongly dependent
on the drug. And some addiction expertsfear that this possibility will have serious consequencesfor the young, noting
that addiction among teenagers is onthe rise in certain cities (New York and San Franciscoamong them). Marijuana use
in teenagers like Dawn can blocksocial development and derail career plans, said Dr. AlanI. Leshner, former director
of the National Institute onDrug Abuse.

People often fail to notice that a friend or neighbor has amarijuana problem because the consequences of cannabis
useare less striking than those associated with other drugs,said Dr. Alan J. Budney, associate professor at theUniversity
of Vermont and director of its TreatmentResearch Center.

"You don't see the severe acute consequences you get withalcohol or cocaine," Dr. Budney said. "People don'tembarrass
themselves. They don't wreck the car. They don'tspend all their money on a binge.

"That doesn't mean it's not addictive. It can be insidious.It gets into your lifestyle and then you can't get it
out."

For years, even addiction experts have argued over theeffect of cannabis.

"There is still some debate regarding the degree, orextent, or magnitude of dependence and what the realconsequences
of that dependence might be," said Dr. BillyR. Martin, a professor and chairman of pharmacology atVirginia Commonwealth
University in Richmond.

One sticking point was the absence of an animal model. Butslightly over a year ago scientists at the NationalInstitute
on Drug Abuse showed that monkeys give themselvesTHC in amounts comparable to that inhaled by people whosmoke marijuana,
according to a study published in NatureNeuroscience. Such self-administration of drugs by animalshas been shown to
be a hallmark of addictive substances.

And more recently, reports have described a withdrawalsyndrome that can last several weeks, another sign ofaddiction.

In a study that followed heavy marijuana users, Dr. Budneyfound that when people quit using the drug, theyexperienced
a host of unpleasant symptoms, includingcraving, decreased appetite, sleep difficulty, weight loss,aggression, anger,
irritability, restlessness and strangedreams.

Often these symptoms drove people back to using the drug,said Dr. Budney, who noted that the marijuana withdrawalsyndrome
was very similar to what cigarette smokersexperienced when they quit.

Still, compared with alcohol, the physical side ofmarijuana withdrawal is mild, experts say.

Nevertheless, for those with a predisposition to be hookedby cannabis, the pull of the drug is intense.

For Mark, a restaurant owner from Vermont, the craving forcannabis was too strong to ignore. Mark, 40, startedsmoking
it when he was 13 and was smoking daily by the timehe hit college. "When I woke up I genuinely didn't feelwell until
I smoked," he said.

Although he tried many times to quit over the years, he didnot succeed until he attended a treatment program.

Still, not everyone is convinced that marijuana is athreat.

"Everything is relative," said Dr. Donald Jasinksi, aprofessor of medicine at the Johns Hopkins medical schooland
director of the Center for Chemical Dependence at JohnsHopkins Bayview Medical Center. "Does it destroy as manylives
as alcohol? No. Does it kill as many people ascigarettes? No. Does it have as many deaths associated withit as aspirin
overdose? No."

Mark, however, wistfully wonders what his life might havebeen like without marijuana. "I'm the only one in my familywho
wasn't an Ivy Leaguer," he said. "I went to a crummycollege. I should have been right up there with the rest ofthem."

--In a PsychINFO search last evening I found another cite from Dr. Miller, asfollows:

The Community Reinforcement Approach to the Treatment of Substance UseDisorders IN American Journal on Addictions,
2001, Vol 10, (Supplement),51 -59. "In 3 recent metaanalyses, Community Reinforcement Approach wasranked as one of
the most efficacious and cost-effective alcoholintervention treatments available. ... resulted in significantly betteroverall
results than did traditional treatments. ... A CRA variant,Community Reinforcement and Family Training (CRAFT) targets
individualsrefusing to seek treatment, by working through significant others. ...Empirical evidence strongly supports
CRA and CRAFT use in substance abusedisorder treatment."

So ... there is a developing base of evidence supporting involvement offamily preservation techniques in both the
adult (CRAFT) and adolescent(MST) populationns.

Study Shows That Youth Need More Drug ProgramsUSA TODAY - February 08, 2002 Nine out of 10 kids who need drugtreatment
are not getting it, a comprehensive federal study of thenation's drug use has found.

The yearlong National Household Survey on Drug Abuse, conductedduring the Clinton administration but issued this
week by theSubstance Abuse and Mental Health Services Administration (SAMHSA),indicates that 1.1 million children
12-17 years old have problemswith drugs and alcohol. Only about 122,000 of them got treatment in2000, the study reports.

''Those kids are only the tip of the (drug abuse) iceberg,'' saysMitchell Rosenthal, head of Phoenix House Foundation,
the nation'slargest non-profit drug-treatment program. The new study confirmsRosenthal's analysis. It shows that about
4.7 million Americans ages12 and older are abusing or dependent on illegal drugs. Of thatnumber, 3.9 million received
no treatment in 2000.

The figures also indicate that the need for treatment has grown overthe past decade.

Previous government studies from 1991 to 1998 estimated that 2.5million to 3.6 million people needed treatment but
did not get it.

Charles Curie, administrator of the Substance Abuse and Mental HealthServices in Rockville, Md., says early intervention
is important.

''We need to target that (young) population. When we interveneearlier, the treatment results can be very effective,''
Curie says.''If we can address the addictive disease, we can give these childrenthe opportunity to get a life and
get a quality life,'' he says.

Bush administration officials say they will focus their efforts on anestimated 129,000 drug abusers of all ages.
That's the portion of thedrug-abusing population that reported in the study that it soughttreatment but was unable
to get it for a variety of reasons.

President Bush asked Congress this week to authorize a $127 millionincrease for drug treatment.

Drug experts say the money is a small step. Treatment for children iscostly and scarce. Yearlong residential treatment
programs can costas much as sending a child to a year of college, and drug programsare almost always at capacity.
Parents often must send their childrenaway for treatment because programs aren't available locally.

Boys who need long-term residential treatment have a month-long waitfor admission to the Caron Foundation drug-treatment
facility inWernersville, Pa., says David Rosenker, vice president of adolescentservices there. Most of them need six
months to a year of anintensive program, he says.

Treatment costs vary widely by the type of facility, thepsychological needs of the patient, and the number and types
of drugsthe person abuses.

''Families that have a lot of money can find access to just aboutanything,'' Rosenker says. ''Then there's everybody
else.''

To close the treatment gap, the government, health care providers andinsurance companies must address funding, insurance
coverage,capacity and the stigma associated with seeking help for drugaddictions, Rosenthal says.

He says the federal government should fund a public campaign toconvince people that treatment works. Changing attitudes
toward drugtreatment will encourage more people to seek help and convincetaxpayers that spending public funds for
long-term treatment paysoff, he says.

Teens: Stats Counter Stereotypes

The Topeka Capital-Journal - February 20, 2002 National Youth Risk BehaviorSurvey, an instrument of the Centers for
Disease Control and Prevention. Therate of teen-age pregnancy is declining, as is the proportion of teenagerswho have
had sex. Cigarette smoking, drinking and the use of most illegaldrugs are down. The suicide rate, although higher than
in other Westerncountries, has held steady for several years.

More students are graduating from high school now than 10 years ago. Schooltest scores are the same as 30 years ago,
with minority students scoringslightly better than minorities in the past. Religious participation isstable, and the
number of young people performing community service has risenslightly, even in parts of the country where service is not
required.

"No one is going to deny the difficulties that teenagers face," Youniss says,"but you can't sustain the argument
that there's something really odd aboutthese kids."

Yet the stereotypes endure, for several reasons, the image changers say. Agesegregation is one. Psychologist Peter
Scales, senior fellow for the SearchInstitute, a Minneapolis think tank on youth issues, notes that fewer U.S.households
contain children or adolescents now than 40 years ago. teenagersdon't have the contact with older adults they once had,
and humans tend tofear that with which they're not familiar.

Scientists who study youths and agencies who serve them frequently mustdemonstrate major deficits in teenagers to
acquire resources from governmentagencies and private foundations. If such specialists aren't careful, theycan easily
conclude that many young people are troubled, and pass on thoseconclusions to an uninformed public.

In "Yes, Your Teen Is Crazy!" (Harbor Press), Philadelphia psychologistMichael Bradley makes such claims more than
the authors of the two other newbooks. To make his case that teenagers are temporarily insane, Bradley drawson the
work of Jay Giedd, a psychiatrist at the National Institute of MentalHealth.

Giedd and other researchers used magnetic resonance technology to show thatthe part of the adolescent brain that
regulates emotions, impulses anddecision-making grows rapidly until age 20. Bradley says this means thatuntil they
reach adulthood, teenagers are "brain- challenged."

As indicated in his book's title, "How to Keep Your Teenager Out of Troubleand What to Do If You Can't" (Workman),
Washington psychologist NeilBernstein focuses most of his attention on problems that can make parentsfeel they're
nearing the end of their rope: "I have dealt with family issuesranging from daily annoyances (sarcasm, dirty rooms, procrastinating
overhomework) to significant crises (antisocial behavior, substance abuse,flagrant defiance. ...) Regrettably my business
is booming."

The book with the scariest title, "Parenting Your Out-of-Control Teenager"(St. Martin's) is the least frightening:
Social worker Scott Sells makes itclear he's describing only those young people who repeatedly demonstrateextreme
behaviors.

Work by the Search Institute suggests otherwise. Six years ago, the institutebegan helping communities identify and
increase the opportunities for localyouths to learn and serve. To date, 560 communities, 24 states and twoCanadian
provinces have signed on to the Search effort.

Starting from old assumptions may not get people to believe anything but theold assumptions, argues Ross Thompson,
psychology professor at the Universityof Nebraska: "As we shift through all the evidence relating to a particularsubject,
we tend to remember that which confirms our earlier impressions anddiscount or forget that which is different."

Monkey Cocaine Study Sheds Light on Drug AddictionBy Will DunhamWASHINGTON (Reuters) - Social standing -- being
dominant orsubordinate -- plays a vital role in determining susceptibility todrug use, scientists said on Tuesday
in a study using monkeys thatmay shed light on human addictions.

Researchers at Wake Forest University in Winston-Salem, NorthCarolina, found that macaque monkeys deemed to be subordinate
insmall groups of the animals were much more likely to give themselvesdoses of cocaine in a laboratory setting than
dominant monkeys.

Brain chemistry linked to social rank explains the phenomenon, thescientists said in a study published in the journal
NatureNeuroscience.

Where an individual monkey stands on the simian totem pole isreflected in a brain chemical called dopamine, which
is intimatelylinked with cocaine and other types of substance abuse, they found.

The dominant monkeys experienced an increase in a type of dopaminereceptor known to be involved in brain pathways
for rewardprocessing, and were less vulnerable to cocaine abuse than theirwallflower laboratory companions.

Michael Nader, who led the study, said the research demonstrated thatenvironmental changes can have a profound impact
on brain chemistryrelating to sensitivity to a given addictive drug -- a finding thatcould have parallels in people.

For example, researchers have pondered why some cocaine users end upas addicts while others do not.

Cocaine acts on the brain by raising levels of dopamine in synapses-- gaps between nerve cells -- with elevated dopamine
levelscorresponding to the ``high'' experienced by the user. Dopamine,categorized as a ``neurotransmitter,'' is released
during normalnerve impulse transmission in the brain.

Nader and his colleagues studied 20 male monkeys. The animalsinitially were housed by themselves for a year and a
half. Theresearchers looked at the monkeys' hormonal activity and behavior,then used a sophisticated imaging technique
to measure chemicalactivity in the brain.

NEW ROOMMATES

A change in living arrangements was then imposed. The monkeys weremoved into groups of four. In the ensuing social
interaction overthree months, dominant monkeys emerged in the five groups, and ahierarchy was established.

The researchers then introduced cocaine to the monkeys, allowing themto self-administer doses. The five top monkeys
were far less likelyto do so than the others.

Brain scans revealed that the dominant monkeys -- those that were themost aggressive and least submissive toward
others -- experiencedmajor changes relating to dopamine starting after the group-housingarrangement was imposed.

Because these changes occurred after only three months of grouphousing and were not seen when the monkeys lived by
themselves, thescientists said the changes in brain chemistry resulted from theprocess of becoming dominant.

``The environmental consequences of those social hierarchies resultedin these changes,'' Nader said in an interview.

``And the changes were in the dominant animals and not in thesubordinate animals. So the positive spin on that is
thatenvironmental enrichment can produce rapid changes in the brain that,in this particular case, protected the individual
from drug abuse.And that is the applicability (to people).''

Nader said the findings involving these monkeys should not beinterpreted to mean that, in people, those at the top
of the socialladder are the least susceptible to substance abuse.

``Not so much that every time you get a promotion or you move up inrank, you're less likely to abuse drugs. I don't
think it's thesocial subordination versus the CEO that's the main point. It's thatenvironmental enrichment ... can
produce rapid and robust changes inthe brain.''

Nader also said he envisions the development of drugs that mimic thebrain chemistry changes that appear to reduce
cocaine susceptibility.But he added that many factors come into play in determining whethera person becomes an addict.

``There are other things going on, for sure,'' Nader said. ''So Ishouldn't say that this is the end-all answer to
everything. But Ithink it is a very promising finding.''

SUNDAY, June 2 (HealthScoutNews) -- The majority of heroin addictscan be treated using a combination of drugs and
psychologicaltherapy, says a new Swedish study.

The study included 40 heroin addicts who took part in group therapyonce a week, had a weekly meeting with a contact
officer and weredrug tested three times a week. Half the addicts were randomlyselected to take a daily dose of 16
mg. of the drug buprenorfin,while the other half received a placebo.

After one year, 75 percent of the buprenorfin-treated addicts werestill in treatment, compared to none of the control
group. Among thebuprenorfin-treated addicts who remained, drug abuse droppeddramatically or ceased and their social
function improved, theresearchers say.

They say buprenorfin does two things: It activates opiate receptorsin the brain, but only to a limited extent compared
to heroin andmethadone; and it reduces or eliminates the craving for heroin. If aheroin addict taking buprenorfin
relapses, the opiate receptors willbe blocked, and the addict won't get the expected high from heroin.

The study was presented at a recent scientific conference in Oslo, Norway.--

Description: Homeless teen who identify as sexual minoritiesexperience more physical and sexual violence, use
more drugs, havemore sexual partners and have higher rates of mental illness thanhomeless straight youth, according
to a new study. (Am. J. of PublicHealth, May-2002)

Homeless youths who are gay, lesbian, bisexual and transgender have aperilous existence on the street. Compared to
heterosexual homelessyouth, they experience more physical and sexual violence, use moredrugs and abuse them more frequently,
have more sexual partners andhave higher rates of mental illness, according to a new University ofWashington study.

The study appears in the May issue of the American Journal of PublicHealth. The National Institute on Alcohol Abuse
and Alcoholism fundedthe research.

"A lot of people believe homeless adolescents are on the street bytheir own choice. That usually isn't the case,"
said Bryan Cochran,lead author of the study and a UW doctoral student in psychology.

"Their lives are something of a revolving door. These youth grow upin horrendous family environments. At home there
can be frequentphysical and sexual abuse, and their parents often abuse alcohol anddrugs. Life on the streets presents
them with new challenges. Butneither place is very hospitable."

The subjects in the study -- 84 sexual minorities and 84 straightyouth, all homeless -- were recruited as part of
a larger SeattleHomeless Adolescent Research and Education Project. Subjects were 13to 21 years old when interviewed.

The researchers found that sexual minorities reported beingphysically or sexually victimized on average by seven
more peoplethan did heterosexual homeless youth. Boys were more likely to havebeen abused in the past three months,
but girls reported moreincidents of abuse while they were homeless. Sexual minoritiesreported leaving home an average
of 12 times compared to seven timesfor straight homeless youth.

The study showed sexual minorities had nearly twice as many sexualpartners in their lives than did heterosexual homeless
youth, 24 vs.13. Both groups reported having unprotected sex about half the time.However, Cochran said, the important
factor is who street youth arehaving sex with and sexual minorities may be more likely to be havingsex with partners
who have HIV or other sexually transmitted diseases.

Many street youth are frequent drug users, but sexual minoritiesreported using 11 of 12 substances more frequently
during theprevious six months. Marijuana was the only substance thatheterosexuals used more frequently, but it was
the most widely usedby both groups.

When it comes to mental health issues, Cochran said the "profiledifferences are striking" for homeless sexual minority
youth. Theyare uniformly at greater risk than other homeless adolescents forpsychological conditions that may require
treatment, such as anxiety,stress, depression and delinquency. In addition, Cochran said theirheavy substance abuse
will exacerbate future psychological problemsand they have a more difficult time dealing with their sexualidentity
than do heterosexual homeless youth.

"People tend to think homeless are an homogenous group. We are tryingto show this isn't true," said co-author Ana
Marie Cauce, a UWpsychology professor. "There are different characteristics andpathways onto the street and what happens
to groups when they are onthe street. It is striking how vulnerable this group (sexualminorities) is.

"Street kids are not cute and cuddly. However, we sometimes losesight of what a tough time adolescence can be. In
the past we used tohave the Army or the ability to "go west" for youth who were having ahard time making it in more
traditional settings. But we don't havethese any more and I worry about these kids in the long term," shesaid.

Cochran and Cauce said sexual minority street youth requireintensified services, and that agencies and groups need
to be awareof potential prejudice because this population has been exposed to somuch rejection based on their sexual
identity.

The study was multi-ethnic, with 53 percent of the subjectsidentifying themselves as white, 19 percent as American
Indian orAlaskan native, 18 percent as black, 7 percent as Hispanic and 3percent as Asian or Pacific Islander. Fifty-five
percent were male.The overwhelming majority, 71 of 84, identified themselves asbisexual. Four females and eight males
identified themselves aslesbian or gay, respectively, and one youth identified as transgender.

Nationally, the estimated number of homeless street youth ranges from600,000 to 1.5 million. The number of sexual
minorities among thispopulation is unknown, although several studies estimate it atbetween 6 percent and 35 percent.

Other members of the research team were Angela Stewart, a UW doctoralstudent in psychology, and Joshua Ginzler, a
research coordinatorwith the UW's Alcohol and Drug Abuse Institute.

Study: evidence-based programs likely to be more successful inpreventing substance use by children(Embargoed)
CHAPEL HILL - Scientifically designed substance abuseprevention programs based on research showing what works and whatdoesn't
are likely to be much more effective in keeping children offtobacco, alcohol and drugs than other programs not based on
suchevidence, a new study suggests.

In part, that's because teachers using such programs tend to havebeen recently trained in teaching them and work
at schools wherestaffers have a positive attitude about making a difference,researchers say.

The national study, conducted at the University of North Carolina atChapel Hill and the Pacific Institute for Research
and Evaluation(PIRE), involved analyzing how teachers and schools discouragesubstance use among middle-school students.

Investigators developed research-based standards for both content anddelivery practices because earlier studies showed
both elements werecentral to the effectiveness of prevention programs, said Dr. SusanT. Ennett, associate professor
of health behavior and healtheducation at the UNC School of Public Health. They then sent detailedquestionnaires to
a random sample of 1,905 middle school teachers tofind out which programs they used in the classroom and how theyimplemented
them.

"We found that about a quarter of the teachers were employingevidence-based programs as opposed to off-the-shelf
curricula thathad not necessarily been evaluated or proven effective," Ennett said."We also found that fewer than
a third of the teachers met thestandards we created. Although that percentage was low, it wastwo-thirds higher than
for those teachers not using an evidence-basedcurriculum, and that's good news."

The UNC researchers were scheduled to present the findings in SeattleSaturday (June 1) at the annual meeting of the
Society for PreventionResearch. Principal investigator for the study was Dr. ChristopherRingwalt of PIRE in Chapel
Hill.

"Both school and teacher characteristics were significantlyassociated with meeting our standards," Ennett said. "Most
notably,providers who were recently trained, reported comfort in usinginteractive delivery methods and were in a school
with a positiveclimate were more likely to implement curricula in accordance withthese standards."

Her group's results suggest that teachers and schools need resourcesand support if evidence-based programs are to
be adopted and used asintended to achieve maximum results, she said.

Examples of evidence-based curricula include Project ALERT andLife-Skills Training. An example of a well-known substance
abuseprevention program not based on evidence is DARE, which recentstudies have found to have little or no effect
in safeguardingchildren.

Programs found to be effective in steering them away from unhealthysubstances emphasized social influences knowledge
and refusal skillsand employed interactive teaching strategies such as role-playing.Such programs also taught them
about social skills, includingdecision-making and assertiveness.

Others involved in the research were Dr. Judy Thorne of Westat inRockville, Md., Dr. Luanne Rohrbach of the University
of SouthernCalifornia and Amy Vincus, Ashley Simons-Rudolph and Shelton Jones ofRTI International.

The National Institute on Drug Abuse supported the new study, whichwill appear in an upcoming issue of the journal
Prevention Science.

Neuronal differences in brain regions involved in decision-making and otherfunctions observed for the first time
in chronic users of cocaine \

Researchers at the University of Pennsylvania have detected differences inareas of the brain in chronic cocaine
users. These differences were detectedin regions involved in decision making, behavioral inhibition, and emotionalreaction
to the environment.

Using magnetic resonance imaging (MRI) and other brain mapping techniques,the researchers, led by Dr. Teresa R. Franklin,
examined 13 men who had usedcocaine for an average of 13 years each. They found that, compared tocontrols who had
never used cocaine, select regions of the brains of thecocaine users had less gray matter. This decrease in critical working
braintissue ranged from 5 to 11 percent. This is the first time in either animalor human studies that differences
in gray matter concentrations have beenfound in chronic cocaine users.

The investigators suggest that some of the behaviors observed in chroniccocaine use- such as choosing immediate gratification
over long-term reward;engaging in risky behaviors, particularly when attempting to obtain cocaine;and succumbing to
the overwhelming desire to seek and use drugs undeterred bythe prospect of future negative consequences- may be a result
of these graymatter deficiencies.

WHAT IT MEANS: Understanding the long-term impact that cocaine can have onthe brain and cognition will help scientists
to develop strategies to reversethose effects and, and, ultimately, restore the brain to normal function.

The study was published in the January, 2002 issue of Biological Psychiatry.It was funded by the National Institute
on Drug Abuse (NIDA).

Impaired memory and motor skills were found in crack-cocaine users up to 6months after their last use of the drug.
Individuals with a history of heavycrack use had the most severe impairments. The researchers believe that thesedeficits
are evidence of brain damage caused by substance abuse.

The NIDA-supported researchers administered a battery of comprehensiveneuropsychological tests to 20 crack-dependent
subjects, 37crack-and-alcohol-dependent subjects, and 29 individuals with no history ofdrug or alcohol abuse. The
tests were given twice-the first time following 6weeks of abstinence from drugs and again after 6 months of drug abstinence.The
tests assessed the subjects' attention span, decision-making, spatialprocessing, immediate and delayed memory, calculation
ability, reaction time,verbal fluency, and psychomotor skills.

Both drug-abusing groups showed significant cognitive impairments at both the6-week and the 6-month time points.
The largest effects were found in theexecutive function and spatial processing assessments.

WHAT IT MEANS: With approximately 2 million cocaine abusers in the UnitedStates, the finding that brain damage resulting
in long-term impaired mentaland physical functioning can result from its use makes developing andutilizing effective
prevention and treatment methods an urgent public healthpriority.

The study was published in the February 2002 issue of Drug and AlcoholDependence by a research team from Neurobehavioral
Research, Inc., CorteMadera, CA; University of Illinois at Chicago; and the Herrick/Alta BatesHospital, Berkeley,
CA. Dr. George Fein was the lead author.

DES MOINES, Iowa (AP) - To outsiders, Debra Breuklander appeared to be atireless single mother of three. She had
an immaculate home in a middle-classsuburb, perfect credit and was a homeroom mom at her children's schools.

She also was taking methamphetamine and selling the drug to make ends meet.

"I thought I was 'Super Mom' and I was doing everything right," saidBreuklander, 43, now serving a 35-year prison
sentence. "In actuality, mythinking was so twisted. I was doing everything wrong."

Breuklander is among a growing number of women who have abused meth, a highlyaddictive stimulant that produces a
euphoria similar to cocaine, but lastslonger and is made from common household ingredients.

Experts and users say meth appeals to women because it's relativelyinexpensive and easy to obtain, and it gives them
energy to take care oftheir children or feel more efficient in everything they do.

"There's no comparable drug that we've ever seen as long as I've been insubstance abuse that appeals to women as
much as meth does," said B.J.VanRoosendaal, spokeswoman for the Utah State Division of Substance Abuse.

Nationally, women made up 47 percent of patients in substance abuse treatmentcenters who identified meth as their
primary drug of use in 1999, accordingto data from the U.S. Department of Health and Human Services.

In Iowa, 43 percent of women entering prison in the first quarter of fiscal2002 said meth was their drug of choice,
compared with 29 percent of men. Infiscal 2000, it was 25 percent of women and 19 percent of men.

More than 40 percent of women arrested in the counties surrounding Honoluluand San Jose, Calif., in 2000 tested positive
for meth use, a NationalInstitute of Justice program found, and the figure was more than 20 percentin several other
areas studied.

Miranda Charbonneau, like Breuklander an inmate at Iowa CorrectionalInstitution in Mitchellville, said she turned
to meth after previously usingmarijuana. It soon became an obsession for the then 16-year-old who had leftschool and
was working.

Every day, the focus was, "where I could get it, who I could get it from, howmuch was it going to cost me ... and
what was I going to have to give up toget it," said Charbonneau, 23, who is serving 10 years for childendangerment.

"I gave up personal items with sentimental value. I sold a lot of mybelongings ... I lost my car, I almost lost my
job. I ended up losing part ofmy relationships with my family," she said. "I began to steal to find ways ofgetting
methamphetamine."

Breuklander, a former nurse who was on disability for a degenerative backdisease, said her relationship with meth
began with financial troubles. Herboyfriend at the time was selling meth and she joined in, selling it to agroup of
friends.

"It all looked glamorous and wonderful and there was such a demand for it,"she said.

"I think for a lot of women, especially single mothers, it gives you theenergy that you think you need to keep the
house, the kids, the yard, thecars, the groceries, the laundry, everything going," she said. "At least,that's how
it took me over."

Sheigla Murphy, director of the Center for Substance Abuse Studies at TheInstitute for Scientific Analysis in San
Francisco, said she started seeingwomen fitting Breuklander's profile in the early 1990s.

"There seemed to be a little proliferation when people started to realizethat cocaine was trouble and that's when
we started seeing more middle-classwomen drinking 'biker coffee,'" Murphy said. That drink is made by addingmeth to
coffee.

"A lot of women use it for performance things or weight control," Murphysaid.

Women "get into this for a lot of what many could consider to be goodreasons," she said.

Women's meth use may initially be more concealed than that of men because ofdifferent reactions when they take it,
said Arthur Schut, president and chiefexecutive officer of the Mid-Eastern Council on Chemical Abuse based in IowaCity.

Men abusing meth get police attention because they are more likely to beinvolved in assaults or to drive drunk. Women
are less likely to do thosethings, Schut said.

Breuklander said everyone thought she was fine because she didn't look like adrug user.

"I did not look like an addict, I did not function like an addict, but I wasan addict and that's a scary thing,"
Breuklander said.

Charbonneau and Breuklander have been treated at a substance abuse program atMitchellville and now are mentors there.
Nearly 100 women are either in theinpatient care program or in after care, which helps prepare inmates fortheir return
to the outside world.

Women spend their day in classes, therapy groups and live in a communalenvironment - all in one room. The treatment
is peer led: they give eachother push ups - congratulating each other for good behavior - and pull ups -telling each
other when they do something wrong.

Breuklander is grateful to the program, but has regrets.

"I have three children. I have missed two of their high school graduations.I've missed their birthdays, I've missed
important things in their life," shesaid. "It ruined my life."

ATLANTA (June 28) - Injury and violence-related behaviors among teenagershave fallen, but more teens are using cocaine
and regularly smoking anddrinking, according to a recent survey.

The Centers for Disease Control and Prevention examined the behavior of13,600 high school students from across the
country for the annual survey,which was released Thursday.

Nearly half of the teens surveyed said they'd consumed more than onealcoholic beverage more than once in the month
before the survey. But anincreasing number are also wearing seat belts and refusing to ride with adriver who's been
drinking.

The number of teenagers who said they had tried cocaine in their lifetimerose to 9.4 percent, up from 5.9 percent
in 1991. About 4.2 percent ofstudents said they had used cocaine in the past 30 days, up from 1.7 percentin 1991.

``We still have plenty of work to do,'' said Laura Kann, a researcher withthe CDC's National Center for Chronic Disease
Prevention and HealthPromotion.

About 46 percent of teenagers said they'd had sex, down from 54 percent inthe 1991 survey. The percentage of sexually
active teenagers who had used acondom increased from 46 percent to 58 percent from 1991 to 1999, butremained at 58
percent through 2001.

The findings point to a failure of ``abstinence-only'' sex-education programsfavored by the Bush administration,
said James Wagoner, president ofAdvocates for Youth, a Washington nonprofit group that supports bothabstinence and
birth-control education for teenagers.

``The implication is clear and yet, the current administration ignores it. Ifyou give young people information about
how to protect themselves, they useit,'' Wagoner said in a statement.

Other findings from the CDC survey:

The number of teenagers who said they never or rarely wore a seat belt fellfrom 25.9 percent to 14.1 percent.

The number of teenagers who said they rode with a driver who had beendrinking fell from 39.9 percent to 30.7 percent.

The percentage of teenagers in daily physical education class fell from 41.6percent in 1991 to 32.2 percent a decade
later.

The percentage of students who carried a weapon decreased from 26.1 percentin 1991 to 17.4 percent in 2001.

"This result provides genetic evidence that marijuana use can resultin schizophrenia or a significantly increased
risk of schizophrenia,"lead researcher Hiroshi Ujike, a clinical psychiatrist at OkayamaUniversity, told United Press
International.

Schizophrenia is one of the greatest mental health challenges in theworld, affecting roughly one of every 100 people
and filling about aquarter of all hospital beds in the United States. For years,clinical scientists have known that
abusing marijuana, also known ascannabis, can trigger hallucinations and delusions similar tosymptoms often found
in schizophrenia. Prior studies also show thatcannabis used before age 18 raises the risk of schizophrenia six-fold.

The hallucinogenic properties of marijuana, the researchersexplained, are linked to a biochemical found abundantly
in the brain.The chemical, called cannabinoid receptor protein, studs the surfacesof brain cells and latches onto
the active chemical within marijuanaknown as THC.

"These sites are where marijuana acts on the brain," Ujike said.

Ujike and his team examined the gene for the marijuana receptor in121 Japanese patients with schizophrenia and an
average age of 44.When they compared this gene in schizophrenics with the same gene in148 normal men and woman of
the same average age, they found distinctabnormalities in DNA sequences called nucleotides among theschizophrenics.
Some of their nucleotides in the marijuana receptorgene appeared significantly more often than normal while othersappeared
less frequency.

"This finding is the first to report a potential abnormality of thecannabinoid system in schizophrenia," said clinical
neuroscientistCarol Tamminga at the University of Maryland in College Park. "Theimportance of a finding here cannot
be overstated, in that it wouldform a tissue target for drug development and allow targetedtreatments to emerge for
the illness."

It appears malfunctions in the brain's marijuana-linked circuitry maymake one vulnerable to schizophrenia, Ujike
said. This holdsespecially true for a condition called hebephrenic schizophrenia,which is marked by deterioration
of personality, senseless laughter,disorganized thought and lack of motivation. These symptoms aresimilar to psychotic
behavior sometimes triggered by severe cannabisabuse, which could mean the marijuana receptors in schizophrenics arefar
more active than they should be.

Ujike stressed there is no evidence yet these genetic abnormalitiescan affect how the marijuana receptor actually
acts in the brain. "Wewould also like to replicate our findings with different ethnicpopulations and more people,"
he added.

The researchers described their findings in the scientific journalMolecular Psychiatry.

(Reported by Charles Choi, UPI Science News, in New York)

SOURCE: Caron FoundationMajor Differences in Addiction and Treatment Between Men and Women,Caron Foundation Reports

WERNERSVILLE, Pa., June 17 /PRNewswire/ -- With increasedavailability of illegal drugs and acceptability of women
drinking andusing drugs, women are approaching a dubious form of gender equality,according to "Women & Addiction:
Gender Issues in Abuse andTreatment," a research report issued by the Caron Foundation, one ofthe nation's most respected
alcohol and drug addiction treatmentcenters. The full report, which includes a self test for women onalcohol and substance
abuse, is available at http://www.caron.org.

"Addiction doesn't have the face most Americans imagine when theythink of an alcoholic or drug addict," commented
Susan Merle Gordon,Ph.D., Caron Foundation research director and author of the report."We have learned that many women
fail to recognize their ownaddiction, probably because they don't see themselves as thestereotypical addict."

Drug use among women is increasing at higher rates than among men.Teenage girls abuse drugs and alcohol at the same
rate as boys, butthe rate of increased use among girls exceeds that of boys. Onceinitiated, women tend to become addicted
more quickly than men, andto experience resulting medical problems sooner.

The report also covers the importance of relationships to women andhow they can have a negative impact. Women are
likely to beintroduced to drugs and alcohol by men with whom they have anintimate relationship, while men are influenced
by male friends oracquaintances. Abuse and trauma, often inflicted by a family member,make girls and women more vulnerable
to addiction. Women tend to besupportive of men in treatment, but male partners are not as likelyto be supportive
of women in treatment.

"Addiction is a deadly disease," said Gordon. Women are morevulnerable to the negative affects of drugs and alcohol
abuse thanmen. Four times as many women will die from addiction-related illnessthan breast cancer. Alcoholic women
are five times more likely toattempt suicide than other women.

"Fortunately, research shows that addiction treatment works, althoughonly 30% of addicted women get treatment," said
Gordon. Those who aretreated in women-only treatment programs are more likely to completetreatment than those in mixed-gender
programs, and have a betterrecovery rate.

The report also covers substance abuse among working women, itsimpact on pregnancy and parenting, and issues for
teenage girls.

Lincoln, (Neb.), July 1, 2002 -- Teen-age runaways in the Midwestreport that physical and sexual abuse were often
the reason that theyleft home, according to the most comprehensive ongoing survey to-dateof homeless runaway youths
in eight Midwestern cities.

"We're not seeing a lot of functional homes sending kids out onto thestreets," said Kurt Johnson, a research sociologist
at the Universityof Nebraska-Lincoln, which is conducting the Midwest LongitudinalStudy of Homeless Adolescents.

"They come from a home life that's not very rosy and they decide togo or are tossed onto the street," Johnson said.
"The questions ourresearch are trying to answer deal with not only how these teen-agersended up on the street, but
what the street then does to them."

According to the three-year, $3 million survey of 455 runaway teensspearheaded by sociologists at the University
of Nebraska-Lincoln,runaways are far more likely than "normal" teens to suffer frommental disorders like conduct disorder,
post-traumatic stressdisorder, substance abuse and severe depression.

"These people were involved or connected with gut-wrenchingexperiences, including sexual abuse and physical abuse,"
saidJohnson, who collects the data from eight full-time survey outreachworkers who visit shelters, the streets, bus
stations, malls andother areas where runaways hang out, to interview them periodicallyover three years.

The ongoing research involves eight Midwestern cities: Lincoln andOmaha, Neb.; Des Moines, Iowa City and Cedar Rapids,
Iowa; Wichita,Kan.; and St. Louis and Kansas City, Mo. Of the surveyed teens inthese cities, 55 are from Omaha, 111
from St. Louis, 60 from DesMoines, 60 from Lincoln, 49 from Wichita, 60 from Iowa City/CedarRapids, and 60 from Kansas
City. Forty-four percent are male and 56percent female.

The survey is the brainchild of Les Whitbeck and Dan Hoyt, two UNLsociology professors who have made a career of
studying homelessteens. They are authors of "Nowhere to Grow: Homeless and RunawayAdolescents and Their Families,"
a book published in 1999 thatresulted from a previous study of 600 runaways.

The current project is in its second year and has just released itsfirst report. "The Midwest Longitudinal Study
of HomelessAdolescents" is being sent to agencies in the Midwest that work withrunaway teens. The report contains
detailed information frominterviews that the survey outreach workers conduct every threemonths with runaways who agree
to stay in touch over the three-yearperiod, typically from age 16 to 19. About 65 percent of the initialgroup of 455
teens have stayed in touch with interviewers, who are inmany cases one of the few adults who express interest in their
lives.

During the interviews, for which the teens are paid $25, Johnson saidnew insights are gained about the lives of these
teens. For example,there are different gradients of runaways, from "couch surfers" wholeave home and sleep on the
sofas of friends and relatives beforegoing back home, to hard-core runaways with their own subculture.Most runaways
stay within a 50-mile radius, although they will travelto other cities, especially "magnet" cities like Seattle or SanFrancisco,
Johnson said.

The study is important for a number of reasons, including troublingsigns that runaway teens are poorly equipped for
adult life, Johnsonsaid.

"Society should worry about what we're doing to these kids by lettingthem live on the street and should ask some
hard questions about whywe're not helping them as much as we should be," he said.

A report summarizing findings from the Midwest Longitudinal Study ofHomeless Adolescents is available, at www.mwhomeless.com. Moredetailed information is available based upon interview information onthe following aspects of runaway life:Basic
demographics Family history Run history Suicide attempts andideation Physical and mental health Diet and nutrition Subsistencestrategies
Victimization and victimizing behaviors Social networksSexuality and pregnancy Help-seeking behaviors Drug and alcohol
useDeviant peers School history and prosocial behaviors

Addiction May Be in the MindHealthScout - July 08, 2002 MONDAY, July 8 (HealthScoutNews)-- People whowant to
break a bad drug habit may have to do more than avoid the sights andsounds that remind them of their addiction.

For years, researchers have known that external cues affect addiction bybuilding up drug tolerance, which makes people
need more and more of a drugto obtain the same effect.

However, internal cues are also at work, says a new study in the July issueof the Journal of Experimental Psychology:
Animal Behavior Processes. Theseearly, internal cues prime the body to react as if the drug effect isimminent.

The finding points out that addiction may be a psychological phenomenon, notjust a physiological one. In turn, that
could help those in treatmentprograms to kick illegal drug use, as well as help doctors prescribe potentpainkillers
more safely.

"The important new finding is that part of the stimuli that elicits thislearned response (to need more and more drug)
comes from early drug effects,"says study author Shepard Siegel, a professor of psychology at McMasterUniversity in
Hamilton, Ontario. These internal cues, he says, are asimportant as external ones.

In the study, Siegel and his colleagues gave rats infusions of morphine overseveral days, so the animals developed
tolerance to the pain-relievingeffects. It takes a few minutes after infusion for the peak effect of a drugto occur.

The researchers hypothesized that every administration would pair the earlyeffects of the drug with the peak effect,
and the animals would begin toassociate the early effect with the later effect.

Next, they gave the animals a very small dose, about 10 percent of what theyhad been getting.

A dose that small usually has no effect, especially after animals are used toa larger one. However, these animals
responded as if a large dose was coming.

"The finding clearly shows that internal cues can be associated withaddiction to a drug," Siegel says. "The finding
should have an effect on cueexposure therapy. Cue exposure therapy is a form of desensitization. It'sused for cigarette,
drug and alcohol [cessation]."

Traditionally, therapists pay attention to external cues, such as a pictureof a syringe. Now, the research suggests
they should also pay attention tointernal cues.

The research may also explain why relapses to a drug habit can be possibleeven when a person is exposed to a small
dose, Siegel says. For instance, arecovering alcoholic may be vulnerable to a single drink because the bodyresponds
to the drug onset cue with a full-blown craving, as if a large doseis coming, and binges.

Siegel suggests desensitization therapy should include small doses to betterreplicate how the body responds to stimuli.

The new research finding builds on a body of research on the role of learningin drug tolerance, says Mark E. Bouton,
a professor of psychology at theUniversity of Vermont and editor of the journal, which is published by theAmerican
Psychological Association.

Besides helping administrators of drug-cessation programs and prescribingphysicians, the research could help those
fighting drug addiction because itshows there are many cues that can stimulate the urge to take drugs, Boutonsays.

"Feeling the urge is not a sign of personal weakness," he adds. "Becomingaware of the cues that might be stimulating
the urge can only help."

What To Do

For information on drug abuse, visit the National Institute on Drug Abuse.For information on prescription drug use
and abuse, check out the U.S. Foodand Drug Administration.

AScribe Newswire - July 19, 2002 LOS ANGELES, July 19 (AScribe Newswire) --It is the world's most commonly used illicit
drug, and perhaps the mostcontroversial of all substances. Marijuana has been at the center of debatefor decades,
with equal numbers calling for its legalization and ban.

In his new book, "Understanding Marijuana" (Oxford University Press, 2002)Mitch Earleywine, an associate professor
of psychology at the University ofSouthern California, attempts to sort out myths and facts about the drug.After analyzing
some 500 studies, Earleywine's ultimate conclusion is mixed -marijuana is neither completely harmless nor tragically toxic.

"The common human desire is to split the world into two categories," saidEarleywine, an expert on substance abuse
and personality "Decisions areeasier when everything is black or white. Yet the world remains in gloriouscolor."

Earleywine looks at the history of medical and recreational marijuana use,cannabis pharmacology, health effects and
treatment.

After examining studies dating from 1681 to 2001, Earleywine has arrived at anumber of conclusions, including:

- Daily marijuana use alters brain function. About 10 percent of regularusers develop troubles ranging from memory
lapses and paranoia to anincreased tolerance to the drug.

- Marijuana does not spur aggressive behavior or impede motivation.

- Marijuana is not a gateway drug and is less harmful than tobacco andalcohol. Less than 1 percent of marijuana users
try heroin.

- While marijuana does help glaucoma, it is not as effective as recentlydeveloped Canasol eye drops, which do not
cause any intoxication and lastmuch longer.

- Users cannot learn new material while they are high on marijuana. Studiesshow an impairment in "free recall" memory
and find that users are unable toseparate relevant from irrelevant stimuli.

- Unlike alcohol or aspirin, marijuana has never been known to cause a lethaloverdose.

- Between 200 million and 300 million people claim to have tried the drug atleast once, with far fewer identifying
as regular users. In the UnitedStates, fewer than 5 percent of Americans report using the drug every week.

Earleywine cautions that an incomplete reading of research can support anyargument for or against marijuana. After
examining the studies, he found thatsome researchers ignored crucial information and data in their finalanalyses.

For example, he said, studies slanted against marijuana legalization mentionthat tetrahydrocannabinol (THC), the
main active chemical in marijuana, oftenappears in the blood of people involved in auto accidents; But the studiesfail
to mention that most of these people also had high blood-alcohol levels.

Similarly, studies slanted in favor of marijuana legalization cite a largestudy that showed no sign of memory
problems in chronic marijuana smokers.However, they neglect to mention that the tests were so easy that even ayoung
child could perform them.

"Researchers' interpretations may tell more about their own biases than theydo about the data," Earleywine said.
"I have tried to avoid this problem byproviding appropriate detail about research so that readers can interpretresults
for themselves."

Earleywine said that some research concludes that marijuana prohibition maycost more than it saves. More than 500,000
people are arrested each year foroffenses related to cannabis.

"Whatever the benefits of marijuana prohibition, the laws also generatecosts. These include the price of law enforcement
and incarceration. Inaddition, the taxes that a legal marijuana market could generate are alsolost," Earleywine said.

The federal government spends $15.7 billion annually on drug prohibition,while state and local governments spend
approximately $16 billion annuallyenforcing drug laws, for a total of nearly $32 billion. Approximately 43percent
(642,000) of the 1.5 million drug arrests in 1996 were for marijuanaoffenses. If all arrests were equally costly, America
spent $13.7 billion onmarijuana arrests - approximately $21,400 for each one, said the researcher.

"Some arrests undoubtedly cost more than others," Earleywine said. "Even ifmarijuana enforcement cost only half this
amount, Americans have clearlyspent billions in an attempt to eradicate this drug, and will likely continueto do so."

September 19, 1999 CRACKS' LEGACYA Drug Ran Its Course, Then Hid With Its UsersBy TIMOTHY EGAN

On a day when Mayor Rudolph W. Giuliani went to Brooklyn to tout the renewal of the Bushwick neighborhood, once considered
one of the most notorious drug bazaars in the country, Pipo Rios opened a 40-ounce malt liquor and contemplated his business
not far from where the Mayor spoke. Rios used to sell crack in the neighborhood, but street-level drug dealers are hard-pressed
to make a living these days, he said. So now he deals in Tommy Hilfiger knockoffs. "I can make more money selling these,"
he said, pointing to a stack of the jackets inside his cramped kitchen, "especially on Friday nights." Rios, 36, said
he no longer used crack, either. But it was not the many times he was arrested, nor the year he spent in prison, that changed
his attitude. He simply grew tired of the drug, he said. Still, the plum-colored marks on his arms are the trademark of another
drug that he does use -- heroin. That, plus tobacco and alcohol. "I've got to quit these cigarettes," he said, shaking
his head in a cloud of smoke. It is unlikely that Rios will ever get invited to City Hall. But the change in his life
is the story of the decline of crack in New York -- done in by age, boredom and new opportunities. Today, in communities
that used to have more open-air crack markets than grocery stores, where children grew up dodging crack vials and gunfire,
the change from a decade ago is startling. On the surface, crack has all but disappeared from much of New York, taking with
it the ragged and violent vignettes that were a routine part of street life. For example, a little triangle of land near
Bushwick, where crack dealers used to stage midnight fights with their pit bulls, is now a community garden. It was a great
year for tomatoes. Over the last 10 years, the New York police made nearly 900,000 drug arrests -- more than any other
city in the world. Almost a third were for using and selling crack. But a broader look at the arc of the crack years suggests
that it was not the incarceration of a generation, or the sixfold increase in the number of police officers assigned to narcotics,
that turned the tide in New York, which the police called the crack capital of the world. Nearly every major American
city plagued by the drug has matched New York's rise and decline in crack use, regardless of how law enforcement responded.
Drug-use surveys, arrest statistics and the personal narratives of scores of users, dealers and street-level narcotics officers
point to the same pattern: The crack epidemic behaved much like a fever. It came on strong, appearing to rise without hesitation,
and then broke, just as the most dire warnings were being sounded. In New York, the use of crack stopped growing as its
addicts became known as the biggest losers on the street. At the same time, the violent drug markets settled down, as dealers
and users fell into retail routines. Perhaps most telling, there was a generational revulsion against the drug. "If you
were raised in a house where somebody was a crack addict, you wanted to get as far away from that drug as you could," said
Selena Jones, a Harlem resident whose mother was a chronic crack user. "People look down on them so much that even crackheads
don't want to be crackheads anymore." The police consider the transformation of parts of Harlem, Washington Heights and
Brooklyn something of a miracle, emblematic of New York's determination to beat back the drug tide that many people thought
would overwhelm it. "I'm not ready to say we won," Police Commissioner Howard Safir said recently. "But we're no longer
the crack capital of the world." He attributed the change to a policy of zero tolerance for anyone using or selling drugs
in the open. "You can spray them once, but they come back," Safir said, comparing drug dealers to cockroaches. "You have
to keep going after them. We had to take this city back block by block." In Washington, however, the drug arrest rates
actually declined in some of the peak crack years -- and the city still recorded a steeper drop than New York in the percentage
of its young residents using cocaine from 1990 to the present. "This happened over a period of time when Washington had
fewer officers on the street, the police made fewer arrests for drugs, and the mayor himself was indicted for smoking crack,"
said Bruce Johnson, a New York social scientist who has conducted extensive surveys of crack use across the country for the
National Institute for Justice. "Something clearly happened to change the attitude among youths," Johnson said. "They
deserve a lot of the credit." The drug that was held up as the scourge of New York is still around, of course, and so
are its consequences -- broken families, battle-scarred neighborhoods, crimes both petty and large. The cheap, smokable form
of cocaine gives its users a quick high and often leaves them wanting more. But a clear trend has developed that few public
officials predicted: Crack has become a drug used primarily by older people. Embraced by one generation, crack was spurned
by the next. The level of crack use has remained steady for more than a decade. According to an annual survey of drug
use among people who are arrested, 35.7 percent of all males over 36 years old who were arrested in New York last year had
used crack recently, but barely 4 percent of those 15 to 20 years old had used it. National surveys of the general population
show the same falling off in crack use among the young. And among all age and race groups, the most startling decline has
been among young blacks, the very stereotype of the urban drug user. A new drug cycle, this time following new ways to
ingest familiar drugs like alcohol, marijuana and even heroin, which is cheaper and more plentiful than ever, has taken hold.
Among many young people in New York, the rage is a "40 and a blunt" -- a 40-ounce bottle of malt liquor and a hollowed-out
cigar packed with marijuana. "You don't find much crack use among the young," said Jean L. Scott, who has worked with
drug abusers for 30 years at Phoenix House in New York, the nation's leading treatment center. "These people saw a whole generation
go bad on crack. They stick with their 40 and a blunt." Crack, she said, the drug that so scared America that it prompted
major changes in the judicial system, in prisons and in police tactics, is barely spoken of among the young in New York --
except with disdain. The Change: Ripple Effect of Aging Users A tentative peace has come to many of the old haunts
of crack. Scouring the New York neighborhoods that once had up to 12,000 open-air drug markets finds only a spectral presence
of the great drug epidemic. The streets are no longer congested with armed boys selling cheap highs by the fistful. A
walk down Knickerbocker Avenue in Bushwick, where three generations of gangsters from Sicily, Puerto Rico and the Dominican
Republic flourished over three different drug cycles, is a tour through the changed cityscape. In the block where crack
dealers shot Maria Hernandez to death in her apartment 10 years ago for trying to unify the neighborhood against them, three
new businesses have come to life. In the park where gunfire could be heard nearly every night, the loudest sound at dusk comes
from two boys arguing over who is baseball's best power hitter, Sammy Sosa or Manny Ramirez. "They're still here, these
crack dealers," said Carlos Hernandez, Maria's widower. "But you can't find them unless you know where to look." A few
blocks away, on Wilson Avenue, a handful of gaunt-faced older men follow a furtive routine to buy $3 vials of crack from an
established dealer not far from the police precinct house. Once, dealers sold crack from the sidewalks. Now they must be summoned
by beeper and code and are wary of selling to strangers. "They no longer own the street," Hernandez said. The police
used to call a stretch of Knickerbocker Avenue the Well -- an endless fount of drugs and violence, sometimes with 25 crack
dealers to a block and three killings a week. "This place has changed dramatically," said Stanley Bauman, 41, a lifelong
resident of Bushwick. For years, he sat on a street corner with a dog named Wacko and sold crack to hundreds of customers.
"Did it right out in broad daylight," Bauman said. "All the cops knew me. And I knew most of them." He was arrested many
times, he said, and did a stint in prison. When asked what happened to his regular customers, he said: "Some of them died.
Some of them went to jail. The others are still using crack, but they're getting old." The aging of the habitual crack
user has had a ripple effect on all the negative social indicators connected to drug abuse. At the height of the crack
years, foster care agencies were swamped with children left in squalor by parents who pursued the crack high; last year the
number of children brought into the New York foster care system fell to fewer than 40,000, down from nearly 50,000 a decade
ago, and child welfare officials attribute the drop in large part to the decline in crack use by women. Ten years ago,
many experts feared that crack would be passed on from mothers to children. But the children did not follow the pattern. "I
remember being 10 years old, and having to take control of my own life," said Ms. Jones, 25, the Harlem resident. "We were
eating cornmeal pancakes without syrup for dinner -- crack vials all over the floor. I was like, 'Hello! Don't you know you
have a daughter?' " Ms. Jones lives near Jackie Robinson Park. Crowded with crack users 10 years ago, it now looks like
any other slice of green in New York on a warm day -- mothers pushing strollers, children playing, clusters of people swapping
stories. Violent crime in New York hit a 30-year low last year, a drop that Giuliani says is largely attributable to the
city's record number of arrests of drug users and dealers. "One of the main reasons crime is down so dramatically in New
York is that we no longer let the drug dealers control the city," Giuliani said. But nationwide, the murder rate also
reached the lowest level since 1969, according to the F.B.I., even in cities where drug arrests fell or remained the same.
A recent study by the Centers for Disease Control and Prevention in Atlanta cited diminished warfare between gangs that
deal in crack as a major reason for the sharp drop in violent crime nationwide. The crack marketplace had become organized.
In Bushwick, the police cordoned off the Well in the early 90's and special teams of officers made thousands of arrests.
So many people were sent to jail that Rikers Island became known as a Bushwick block party, said Dr. Rick Curtis, a cultural
anthropologist at John Jay College of Criminal Justice in Manhattan, who has interviewed more than a thousand crack users
and dealers in Brooklyn over the last decade. "Even the drug dealers were happy to see a certain level of sanity return,"
Dr. Curtis said. "The question is, would this have happened anyway? Drug markets were in contraction well before the stepped-up
police action." Arrest statistics show that crack use among the young started to decline nearly 10 years ago, in the administration
of Mayor David N. Dinkins. In Philadelphia, Los Angeles, Washington and other cities where the drug took hold about the same
time as in New York, in the mid-80's, crack fell out of favor at the same time. "You used to see crowds of people waiting
to buy their crack kept in line by some jerk with a baseball bat," said Robert Baumert, a retired deputy chief who was in
charge of narcotics enforcement in north Brooklyn at the peak of the crack years. "They were not afraid of the police." Longtime
crack users agree with the police on at least that point: They did not fear the law. But the large police actions, the sweeps
that had names like Operation Striker, did not ultimately deter use, they say. In a 1997 survey that asked crack users why
they had given up the drug, only 5 percent cited arrests or jail. Nearly 19 percent said they "grew tired of the drug life."
"I don't think anything the police did changed my behavior," said Thomas Covington, who was arrested 31 times, mostly
for crack possession, and served two prison terms before voluntarily entering drug treatment. "Sometimes it was a little more
challenging to buy. But once that compulsion is there, it doesn't matter what the penalty or the threat is." Covington
is a big, sharp-witted Brooklyn native who has used crack on and off for 15 years. He made it through the explosive violence
that came with crack's introduction. He was homeless, and sick, and twice felt the steel tip of a handgun pressed to his temple
by hot-tempered dealers. He dodged the police offensives of three mayors. But starting in the early 90's, Covington
said, he noticed a shift in the attitudes of young drug dealers. "They didn't use crack," he said. "And they didn't respect
people who did. To me, being a 34- or 35-year-old guy, standing on line and handing my money to a 15-year-old, that was humiliating."
The Bad Times: Getting Better Amid Despair At the lowest point of New York's long night of despair over crack, the
city was nearly broken by the drug. Or so it appeared. During one rush hour 10 years ago, 149 subway trains came to a
sudden halt, held up by an electrical short. It was one of the more unusual casualties of crack, transit officials later concluded.
Pawn shops paid $1 a pound for copper, and drug users found that few things brought in money like the two-inch-thick copper
wires that help guide subways around New York. "We used to rip the cable out and then burn off the insulation," Covington
said. It was just this sort of scavaging, transit officials said, that led to the subway short. In the crack years, the
city had an aura of menace. In 1989 a police officer, Edward Byrne, was killed while guarding the home of a witness in a drug
case in Queens. In 1990, a record 2,262 people were slain, and the police linked two-thirds of the deaths to the drug trade.
Other drug addicts were afraid of the hard-core crack users. Doris Randolph, a former drug user in Harlem who now helps
young people stay off drugs, said, "The people who used heroin, we'd be sitting there in the shooting galleries, nodding,
talking politics, talking about music, the paper under our arms, and then all of sudden these twitchy crackheads showed up,
and they looked dangerous." But as early as 1989, four years after crack's appearance, at a time when New York looked
to be at its lowest ebb, the fever had broken and the epidemic was beginning its slow decline. It continued to fall before
and after the major police crackdowns, until it hit a plateau in the mid-90's where it has been ever since. Mandatory
prison terms and hundreds of thousands of arrests "appeared to have no major deterrent effect," according to a study of crack's
decline by the National Institute of Justice. Dr. Lynn Zimmer, a professor of sociology at Queens College, who studied
the effects of police sweeps on drug use in New York in the late 80's, said: "Crack would never be as popular as it was made
out to be, and people who really understood drug cycles predicted that. There is a natural cycle to these kinds of drug trends.
Crack followed that." Growing up with a crack-addicted mother, Ms. Jones said, she could tell the drug would never be
popular with the children her age. "You'd see things that were just crazy," she said. "My mother used to like going to jail.
She'd get her rest there. She said all her friends were there." The Campaign: Driving Dealers Underground A stroll
down West 139th Street in Manhattan, in the heart of a square mile that the New York police once called the cocaine capital
of the world, found 71-year-old Casimiro Lopez relaxing on the stoop at dusk. "I'm telling you: the drugs never finish,"
said Lopez, who has lived here for 31 years. "But it's much better now, because you don't see them anymore." Much of West
139th Street was taken over by the New York police in the mid-90's in what the officers call a model-block campaign to reclaim
neighborhoods from drug dealers. They put barricades at both ends of the street and stopped people who could not prove that
they lived in the neighborhood. From 139th north, through Washington Heights, the police carried on similar campaigns: taking
over entire blocks, arresting people for minor offenses, then hanging N.Y.P.D. banners, planting a row of trees and moving
on. Signs posted on the outside of apartment buildings read: "No Hanging Out. No Eating. No Pets. No Loud Radio." Many
residents welcome the police attention. Others compare it with martial law. "The idea is to blanket the city and give
drug dealers no place to hide," Giuliani said in explaining the city's policy. "It's working." But scores of interviews
in these hard-hit neighborhoods found many people who felt that the change had been largely cosmetic. "I compare it to
Niagara Falls," said Jordi Reyes-Montblanc, director of the West Side Heights Citizen League. "You take 10 buckets out one
year, 100 buckets out the next. That's a 500 percent improvement, but the falls are still in place." Drug dealers are
indeed hard to find on West 139th Street. But a few blocks further north, men in their late 30's and early 40's make deals
in the shadows around Our Lady of Lourdes Roman Catholic Church and the two-story, wood-frame house built in 1802 by Alexander
Hamilton, a framer of the Constitution. "What the police did was move the drug traffic north," said the Rev. Thomas Fenlon,
pastor of Our Lady of Lourdes, a church with bars over the stained-glass windows. "Now, instead of being on 139th Street,
they are in front of the church and school." But over all, he said, there are fewer dealers, and his comments were echoed
throughout old crack alleys. Crack users told of going inside to buy, using beepers and code, and pretty much going on as
usual within a block or two of the street where the N.Y.P.D. banners flew. "Everything went underground," said Rolando
Lopez, an antique furniture restorer from Brooklyn who has had a crack habit for much of the 90's, but has never been arrested.
"It became more of a thrill. You'd walk by the cops, carrying the crack vial in your mouth." Covington in Brooklyn also
changed his buying routine, but not his habits. "Instead of buying in the street, we started buying from some of the bodegas,"
he said. "You'd go in and order a hero sandwich in the back, and they'd put the crack in a bag with some chips." The police
say they have tried to do something considerably more difficult than showing an iron fist 24 hours a day. "We're not just
coming in and locking up dealers like an invading army," said Capt. Garry F. McCarthy, who until recently was in charge of
the 33d Precinct, which includes most of Washington Heights. "We're coming in and trying to create a livable community." But
others says more credit should be given to the people of the neighborhoods. No matter how many trees they plant, banners they
fly or arrests they make, the police cannot create a livable community, they say. It takes human resiliency. The Rebirth:
Neighborhoods Heal Themselves It has been a prosperous decade. Disney and the Gap are now coming to Harlem. Bushwick
and Washington Heights are alive with new bodegas, farmicias, fruit markets, discount clothing stores, chains like McDonald's
and Rite Aid. Bauman, the former crack dealer in Bushwick, now works on construction crews, putting up plasterboard. "I
got all the work I can use," he said. One of his fellow dealers has become a security guard. Another is a school bus driver,
said Dr. Curtis, the anthropologist. In Bushwick, Dr. Curtis concluded, the neighborhood healed itself. Many people
had expected the arrests to continue without end, until Bushwick was a place nearly devoid of young men. But social pressure
and neighborhood initiatives brought a change. "Rather than fulfilling the prophecy of becoming addicted and remorseless
superpredators," Dr. Curtis wrote in his study, the young men of Bushwick "opted for the relative safety of family, home,
church and other sheltering institutions, which persevered during the most difficult years." Hernandez of Bushwick gives
the police plenty of credit for the change in his neighborhood. But he says it was more than arrests that made crack's imprint
diminish in his small piece of New York. The crack epidemic looked like it would never end only to those who could not see
to the other side, he said. "The community came together, and it created a snowball effect," said Hernandez, walking down
Knickerbocker Avenue in bright sunshine. "The churches, the merchants, the parents -- we showed young people there was something
to live for here in Bushwick." His family is the best proof of his point. Hernandez's eldest daughter, Evelis, having
completed college, has decided to return to Bushwick. She will soon be teaching school in the neighborhood where her mother
was shot to death. "Why should we ever leave?" Hernandez said.

Drug Use Down In U.S., Up In Europe WASHINGTON, Oct 22 (AP) — Illegal drug use is falling in the United States
but rising sharply in Europe, U.S. officials say. The amount of drugs seized in Europe more than doubled this year as South
American traffickers targeted the continent. Barry McCaffrey, President Clinton's chief drug policy adviser, is holding
a series of drug summits across Europe next week to address the problem. He is also pushing for a drug-free Olympics. Anti-drug
authorities classify 13 million Americans as current illegal drug users, compared with 25 million in 1980. Cocaine use has
dropped the most dramatically, from 5.7 million in 1985 to 1.8 million, according to McCaffrey's Office of National Drug Control
Policy. A current drug user is anyone who used drugs at least once in the past month. Comparable statistics are not
available for most of Europe, although surveys taken in recent years show cocaine use ranging from 0.5 percent of the population
in Belgium to 3.3 percent in Spain. Ross Deck of McCaffrey's office, who has been meeting with European officials tracking
drug use, said there is ample evidence that drug use is increasing across Europe although countries are only beginning to
compile statistics. "Cocaine is looking for new markets," McCaffrey said at a news conference Thursday, and it's finding
them in Europe, where attitudes toward some narcotics differ from those in the United States. The International Narcotics
Control Board, in its latest report, cited increased demand for illegal synthetic drugs in Europe and said heroin use is up
in some countries. It said preventing illegal drug use is difficult on a continent "where it is increasingly being viewed
as an almost normal cultural phenomenon." It said cocaine use is not seen as a major public health problem. The board,
based in Vienna, Austria, said Europe is not only a major destination for drugs, including heroin, but an emerging producer
of marijuana and illegal synthetic drugs such as "ecstasy." McCaffrey said Americans need European help in stopping
the flow of 700 metric tons of cocaine a year from Colombia, Bolivia and Peru, about half of which still ends up on U.S. streets.
McCaffrey leaves Sunday for meetings with officials in Britain, Belgium, Portugal and France. He said his message will be
that cocaine is not a soft drug and that Europeans should contribute more in the battle against narcotics from Latin America.
He credited good police work by the Spanish and Dutch for much of a sharp increase in cocaine seizures this year, but he said
the increase in busts every year for six years "is indicative of a changing problem."

McCaffrey said Europeans should contribute more to alternative economic development in the Andean region and step up
efforts to stop drug production and money laundering. "I want to make sure they get the point that they are now the
target of a drug threat that is searching for new customers," McCaffrey said. Another focus of his trip will be on the
use of performance enhancing drugs in sports, McCaffrey said, leading up to a Nov. 14-17 Australian sports summit aimed at
eliminating drug use by athletes in the 2000 summer Olympics in Sydney and the winter games in Salt Lake City, Utah.
"We've got to come up with some notion on how to create a level playing field, where competitors don't think you have to chemically
engineer the human body, or you can't win," McCaffrey said. McCaffrey, in an interview, said his foreign travel and
his participation in a planned Western Hemisphere 34-nation drug summit Nov. 9-10 is justified by the need for international
cooperation to stop the flow of drugs into the United States. His top goal, he said, is to educate and enable American youth
to reject illegal drugs as well as alcohol and tobacco. "It's an interdependent world," he said. "Clearly, you've got
to have a cooperative relationship" with other countries on money laundering, trafficking, doping in sports and other issues.
McCaffrey's office estimates that 80 to 130 metric tons of cocaine is available for consumption in Europe, with expected seizures
this year of 40 to 50 metric tons. In the first six months of the year, seizures were already double those of last year, it
said.

The report estimates that 57 percent of the South American cocaine flowing into Europe lands in Spain or Portugal, 15
percent in the Netherlands, 6 percent in Belgium and 7 percent at unknown entry points.

Group Seeks to Educate Physicians about Treating AddictionDisability Issues Column, Tallahassee, FL : Oct. 29--Someone
you know is chemically dependent. And more likely than not,that person isn't going to be a street criminal but an everydayindividual
who holds a job, has a family and is involved in thecommunity.

Under Title V of the Americans with Disabilities Act, people who arechemically dependent and in the recovery process,
includingwithdrawal, are technically considered those with a disability andare afforded all rights under that federal
law. Those rights, ofcourse, include the basics such as employment and disability programentitlement.

Chemical dependency has entered the realm of science, and theoriesnow exist as to not only why people become addicted
but what happensto the brain and the body in the process. This year the AmericanSociety of Addiction Medicine will
hold its biannual conference onthe "state of the art" in medicine and the treatments of the variousaddictions ranging
from alcohol to cocaine. An estimated 300 medicalspecialists, educators, researchers, clinicians and counselors areexpected
to attend.

ASAM's goal is to educate doctors and other health care professionalsabout the entire dependency process.

"As always, the November conference will offer cutting edge updates,"says Terry K. Schultz, ASAM conference co-chair.
"Our learning goalsinclude ways to develop and understand the structure and theneuro-chemical diseases of the brain.
We realize now how these drugsaffect the central nervous system, their neurotoxicity and thechanges they cause in
the brain.

"We also understand the basics for relapse, things such as cognitiveimpairment, the dysfunctional ways people cannot
handle stress laterand their disordered sleep."

The ASAM conference is set to begin at 7 a.m. Nov. 4 and run untilNov. 6 at the Marriott at Metro Center on 12th
Street N.W. inWashington, D.C. The cost to attend ranges from $50 for a student upto $475 for a professional. Attendees
can register at the lastminute. More than 25 topics are slated for discussion.

In the United States, ASAM estimates roughly one in 10 Americans hasan addiction or roughly 10-15 percent of the
adult population. Thetop drugs for dependency issues include nicotine, alcohol, theopiates (including prescription
drugs) and cocaine. Other largegroups of these substances include amphetamines and the so-calleddesigner drugs, the
newer "street" drugs such as GHB, thebenzodiazepines, barbituates, sedatives and hypnotics; thehallucinogens, the
inhalants and marijuana.

Issues of dependency touch the lives of those who take prescriptionnarcotics for chronic pain to those who come into
contact with thebenzodiazepines for everything from restless leg syndrome to avariety of sleep and anxiety disorders.
The dose can be small over aperiod of weeks or it can large over a period of years. Thedependency process knows no
one class or group of people.

James Callahan, ASAM's executive vice president, says theorganization now has about 3,200 members in the United States,Canada,
France, Germany, Venezuela and other countries.

While ASAM is primarily for the clinician, it does have a few generalservices. It publishes the "Principles of Addiction
Medicine," forroughly $150 (which discusses all types of addiction in its 1,300pages) and it also publishes the "Patient
Placement Criteria," whichis available for $55. The group have a chapter referral listing,which acknowledges some
30 chapter leaders from around the country.

Callahan also recommends other sources for the public wantinginformation on addiction. These include the National
Institute onDrug Abuse in Rockville, Md. the National Institute on Alcohol Abuse,also in Rockville; and the National
Clearinghouse for Alcohol andDrug Information at 1-800-729-6686. The last group is also inRockville and has a free
50-state directory called "The NationalDirectory of Drug Abuse and Alcoholic Treatment Programs." The booklists treatment
centers and counselors in all 50 states for a varietyof dependent chemicals.

Meth Clinic Treats ChildrenNovember 8, 1999

DES MOINES, Iowa
(AP) — A decade ago, when Dr. Rizwan
Shah decided to open a clinic to treat children exposed to drugs,
she thought it would take up just a fraction of her work schedule
five hours a week, at most.

But with the rapid
rise of methamphetamine use in the Midwest,
running the one-of-a-kind program has become a full-time job.

``This is beyond
what I could have anticipated,'' she said recently.
``In 1989, when I started my clinic, perception of people in Iowa
and people anywhere in the United States was that Iowa, the
Midwest, is not the place where you have drug abuse problems.

``Ten years later
we find out that rural communities and small
towns are as likely to have an epidemic of substance abuse
among pregnant women as big cities.''

Methamphetamine
use has spread rapidly since the mid-1990s,
forcing doctors like Shah to learn how to treat children mostly
infants exposed to the drug while in the womb.

Born in Pakistan,
Shah came to Iowa in the early 1970s with her
husband, who also is a physician.

After noticing
growing numbers of pregnant women taking drugs,
she started the infant treatment program at Blank Children's
Hospital. In the first four years of the program, about 70 percent
to 80 percent of her patients were babies exposed to cocaine.

Since 1993, when
she treated her first infant exposed to
methamphetamine, she's examined 368 other such cases
underscoring the drug's rapid rise in the state.

Shah estimates
about 90 percent of the children she now treats
are methamphetamine cases.

``The ability
with which methamphetamine became an epidemic
was a surprise,'' said Shah, a 57-year-old mother of three. ``One
of the reasons is its popularity among the rural populations. It's
just like a wildfire.''

In Iowa in 1994,
629 people were arrested for drug possession
that included methamphetamine, according to the Iowa
Department of Public Safety. Last year, that number surpassed
1,700.

The drug's popularity
also has led to a striking rise in the number
of methamphetamine laboratories busts jumping from eight such
busts in 1995 to 374 already this year. The state's division of
narcotics expects the number to surpass 400 by year's end.

Signs of meth
exposure in children include overstimulation of the
brain, muscle-tone problems, periodic shaking and tremors,
difficulty with coordination and an intolerance to human touch.

Some of her older
patients, between the ages of six or seven, are
often susceptible to hyperactivity, attention deficit disorder,
learning disabilities and ``unprovoked anger fits'' in which children
become destructive for short periods of time.

Medical experts
around the state are pressing for more funding to
deal with the scope of the problem.

Shah wants to
study and compare children affected by cocaine
with children exposed to methamphetamine. She has proposed a
formal study through the National Institutes of Health and hopes
to begin research next year.

Cheryll Jones,
health services coordinator at a clinic in Ottumwa,
agrees that more studies are needed.

``They've looked
at cocaine fairly closely, but not really at meth,''
she said. ``We need funds to follow these children over time so
we can more accurately say what is the outcome of these children
over time.''

Aside from health
problems, another consequence of the drug
epidemic is that the children often wind up separated from their
natural parents. Shah says about 68 percent of her patients have
been adopted or placed in foster care.

But there are
those willing to take in the children.

For one Iowa couple,
taking care of their adopted daughter who
had been exposed to methamphetamine is a blessing. Doctors
said the girl had suffered a heart seizure hours before she was
delivered.

``We just wanted
to give her the most normal life possible,'' said
the father, who asked that his name not be used.

``For us, she's
a miracle baby.''

Copyright 1999
The Associated Press. All rights reserved.

"Chasing The
Dragon" Heroin Use
Can Damage Brain

November 10,
1999

NEW YORK (Reuters
Health) — Heroin users who heat the
drug and then inhale it — a practice called "chasing the dragon"
— risk serious brain damage or death, researchers report.

This form of heroin
use is "increasingly popular," the authors point
out, because people believe it will protect them against
transmission of HIV and other diseases associated with injecting
heroin.

But the practice
carries a risk of untreatable brain damage, with
death due to progression of brain damage occurring in about 20%
of cases. This month in the journal Neurology, Dr. Arnold
Kriegstein and colleagues from Columbia University and other
New-York based medical centers describe three patients who
developed symptoms of a rare brain disorder, progressive
spongiform leukoencephalopathy, following regular inhalation of
vapor produced by heating powdered heroin on aluminum foil.

In this type of
brain damage, fluid-filled spaces cover the brain's
white matter, and patients develop symptoms such as loss of
coordination and difficulty moving and talking.

The first reports
of this rare brain disorder came from the
Netherlands a number of years ago, when 47 addicts who had
"chased the dragon" first had symptoms of slowed movements
and impaired walking ability, but which progressed to varying
degrees of paralysis, tremor and blindness in some users. Eleven
out of the 47 patients died, which is a very high mortality rate.

The three patients
described by the New York group are the first
cases of spongiform leukoencephalopathy to be reported in the
United States. Imaging studies of the brains of these three patients
were done and researchers made detailed observations on each
of the three patients following hospital admission. The first patient
was a 21-year-old woman who had been inhaling heroin vapor
daily for about 6 months.

Just before she
was admitted to hospital, she was inhaling four to
five bags of heroin a day, and on admission, her symptoms
actually worsened even though she had stopped using heroin.
"She was really in very grave condition," Kriegstein told Reuters
Health in an interview. Although no treatment exists for this
disorder, the New York team decided to treat her with an
antioxidant 'cocktail' consisting of high doses of vitamin E, vitamin
C and coenzyme Q. Two years later, the patient has only mild
movement problems.

The second patient
treated by the New York team was a
40-year-old man who had also been inhaling heroin vapor for
some time. Prior to admission, he had become progressively
uncoordinated, and had developed slurred speech. Doctors
placed him on the same high-dose antioxidant cocktail they had
used for the first patient.

Five months after
being treated, the patient still had some
movement problems and he had developed a tremor, which
impaired his ability to carry out certain activities.

The third patient
in the report was a 28-year-old man who had
inhaled heroin vapor on occasion with the other two patients.
Although this patient's symptoms were much less severe, he still
had signs of abnormal movement when doctors examined him.

Kriegstein noted
that on imaging the brains of these patients, the
group saw significant abnormalities in the cerebellum, the area of
the brain that controls coordination of movement.

"These abnormalities
improved but they did not return to normal
even when patients themselves recovered to near normal," he
said.

This suggests
that inhaling heroin vapor may cause permanent
brain damage, he added, and that more serious symptoms may
re-emerge as the patient ages. The other real concern, Kriegstein
said, is that many more patients may be at risk for the same brain
damage as a result of the growing practice of "chasing the
dragon."

"There is a certain
heroin chic surrounding this mode of use that
gives it an ominous appeal among the more affluent users,"
Kriegstein explained. "So our concern is that more patients may
develop this illness, (which) is extremely grave and has no known
treatment. Patients may improve gradually over months to years,
but most patients do not return to normal."

The research team
notes that the toxin causing the brain damage in
these cases is not known, but progression of the illness may be
due to "ongoing oxidative damage" initiated by a toxin. Kreigstein
noted that there are estimates put the number of "hard-core"
heroin users in the US at between 500,000 to 1 million. "We
suspect that there may be many more cases (of heroin-related
brain damage) that are being misdiagnosed," he stated.

SOURCE: Neurology
1999;53:1765-1773.

Copyright 1999
Reuters Limited. Cocaine Use Can Lead To Aneurysms
November 12, 1999
The Medical Tribune
More bad news for cocaine users. A new study finds, for the first
time, that cocaine use can lead to the development of aneurysms in
heart arteries. The research, presented Tuesday at the American
Heart Association Scientific Sessions in Atlanta, found that use of
cocaine, already linked to an increased risk of heart attack and
stroke, can triple the risk of an aneurysm.

"I would hope
this would discourage people from using cocaine at
all," said Dr. Aaron Satran, chief medical resident at Hennepin
County Medical Center in Minneapolis. "We didn't prove causation
in this study, but we did show there's a strong association between
cocaine use and the presence of coronary artery aneurysms. It just
adds to the long list of bad things that cocaine can potentially do to
people."

The researchers
looked at 112 individuals who admitted using
cocaine. All had a history of chest pains and other cardiovascular
health problems, and all underwent an imaging test called
angiography, in which dye is injected into the arteries and an X-ray is
taken. The average age of the study subjects was 44, and 80 percent
were male. The study found that 30 percent had aneurysms in a heart
artery.

"This is an extremely
high percentage, compared to the overall
number of coronary artery aneurysms seen among patients referred
for angiography," said Satran. "The extremely high number of people
who had aneurysms was surprising."

"After observing
severe coronary artery aneurysms in a large number
of young cocaine users, we wanted to determine if the drug was the
cause of these aneurysms," said Satran. "Our findings strongly
indicate that cocaine use is associated with an increased risk of
aneurysms, and that the more cocaine consumed, the higher the risk
of developing an aneurysm."

In addition to
their increased risk for developing an aneurysm, 73
percent of those in the study had high blood pressure; 71 percent
had high cholesterol levels; and 95 percent were cigarette smokers.
"The study provides evidence that cocaine use is associated with
higher risk of cardiac damage and accelerated development of
atherosclerosis," said Satran. "We do not believe this damage is
reversible," he added.

Dr. Rose Marie
Robertson, professor of medicine at Vanderbilt
University in Nashville, Tenn., and president-elect of the American
Heart Association, said the study's findings have the potential to
change some people's attitudes about cocaine use.

"This is an extremely
interesting study," said Robertson. "Coronary
aneurysms are quite rare in the non-cocaine-using population. It will
cause us to think about cocaine's effects and coronary aneurysms in
a new way. It also gives us a new image to utilize. People thinking
about aneurysms ballooning out in their arteries would find that more
frightening, and this will help us have an impact on people who might
otherwise use these kinds of drugs."

Copyright 1999
The Medical Tribune News Service. All rights
reserved.

HHS SUBSTANCE ABUSE INITIATIVES, RESEARCH, AND PROGRAMS Marijuana Initiative. To reduce marijuana use among American
youth, HHS in July 1995 began a comprehensive Marijuana Initiative. As part of this initiative, HHS has funded new research
on the effects of marijuana, and launched major prevention-oriented campaigns to help parents educate children about the dangers
of drugs -- like the "Reality Check" anti-marijuana campaign. In December 1998, the National Institute on Drug Abuse (NIDA)
kicked off its NIDA Goes to School Initiative distributed information kits to every middle school in the United States. The
kits contain research-based materials, including the award-winning "Mind Over Matter" poster magazine series and "Marijuana:
What Parents Need to Know," and "Marijuana: Facts for Teens." These and other free materials may be obtained by calling 1-800-729-6686.
HHS has also conducted outreach to the media and entertainment industries, enlisting their help in communicating the facts
about marijuana to the American people; and implemented an aggressive communications strategy, including collaborations with
Weekly Reader, Scholastic and Reader's Digest magazines and the National Association of Broadcasters, to reach children in
their homes and in their classrooms with messages of prevention.

National Youth Anti-Drug Media Campaign. In 1997, President Clinton launched the bipartisan-supported National Youth
Anti-Drug Media Campaign. The Campaign uses the full power of the modern media from television, radio, the Internet, newspapers,
magazines to sports marketing to educate young people to reject drug use. Complementing several HHS' initiatives, the Campaign
also targets parents, teachers, mentors, coaches and other responsible adults to help them talk to kids about drugs and get
more involved in the lives of young people.

The first nationally representative study of substance abuse treatment results confirms that both substance use and criminal
behavior are reduced for at least five years following inpatient, outpatient and residential drug abuse treatment. The Services
Research Outcomes Study (SROS) was conducted by the Office of Applied Studies of the Substance Abuse and Mental Health Services
Administration (SAMHSA). Findings of the study were determined through interviews with 1,799 persons (71.4 percent male
and 28.6 percent female) who had undergone substance abuse treatment at 99 facilities selected from a random sample of treatment
programs across the nation. All 1,799 clients were interviewed five years following discharge from drug abuse treatment and
are representative of the 976,012 individuals discharged from treatment in 1990. Five years following treatment there
was a 21 percent reduction in the use of any illicit drug; a 14 percent decline in alcohol use; a 28 percent decrease in marijuana
use; 45 percent drop in cocaine use; a 17 percent reduction in crack use; and a 14 percent decrease in heroin use. Further,
the findings confirmed results of previous studies showing that treatment significantly reduces not only substance use, but
crime as well. According to the study, most criminal activity, including income-producing crimes (breaking and entering, drug
sales, and prostitution) and violent and disorderly offenses (driving under the influence and weapons use) declined by at
least 23 percent and as much as 38 percent following substance abuse treatment. HHS Secretary Donna E. Shalala said, "These
research findings confirm numerous past studies establishing the critical importance and success of substance abuse treatment
programs. September is Recovery Month. These findings should serve as a wake up call that we continue to face a serious treatment
gap. I urge Congress to move quickly to approve the Administration's drug prevention and treatment budget which includes a
$200 million increase in block grant money for the states to expand their substance abuse treatment and prevention programs."
Barry R. McCaffrey, Director of the White House Office of National Drug Control Policy, noted that "the SROS report provides
solid evidence that substance abuse treatment plays a critical role in our effort to meet the demand reduction goals of our
nation's Drug Control Strategy. As we kick off this month's observance of Recovery Month, we need to encourage more people
to seek treatment and redouble our efforts to insure that quality treatment is available." "These findings," said SAMHSA
Administrator Nelba Chavez, Ph.D. "Clearly show what we have been saying for years 'Treatment rebuilds lives, treatment can
and does put families back together and restores the recovering substance abuser to productivity.' We are proud of the treatment
successes confirmed by this new report. We must, however, continue to pursue several fundamental questions: Why do some people
not complete their treatment; why does treatment work for some, but not for others; and how can we make treatment more relevant
to individual needs, cultures and situations. There obviously is much work left to be done and this Administration is committed
to giving anyone caught up in substance abuse a chance at a second beginning." These findings are being released during
National Alcohol & Drug Addiction Recovery Month. This ninth annual observance is designed to recognize the extraordinary
work of substance abuse treatment professionals and the contributions and achievements of people in recovery. The theme for
this year's celebration is "Addiction Treatment: Investing in Communities." The Services Research Outcomes Study was conducted
by the National Opinion Research Center, University of Chicago, for SAMHSA's Office of Applied Studies. The Services Research
Outcomes Study and the National Alcohol and Drug Addiction Recovery Month Kit are available on the Internet at www.samhsa.gov, or may be ordered by contacting the National Clearinghouse for Alcohol and Drug Information at 1-800-729-6686; TDD (for
hearing impaired), 1-800-487-4889. For more information about Recovery Month, contact the Office of Communications & External
Liaison, Center for Substance Abuse Treatment, at (301) 443-5052. SAMHSA, a public health agency within the U.S. Department
of Health and Human Services, is the lead Federal agency for improving the quality and availability of substance abuse prevention,
addiction treatment and mental health services in the United States. The Center for Substance Abuse Treatment is part of SAMHSA.
###

For more information, check the SAMHSA website at www.samhsa.gov. Drug use down among US teens

NEW YORK, Nov 22 (Reuters Health) -- Pollsters report that for the firsttimein years, the popularity of illegal
drugs is on the decline among US teens."Attitudes are changing for the better," commented James E. Burke, chairmanof
the Partnership for a Drug-Free America, which sponsored the nationwidesurvey of more than 6,500 teenagers, 13 to 18 years
old. He said, "Acrosstheboard... teenagers are disassociating drugs from critically important badgesof teen identity."

Use of a wide variety of illicit drugs had been on the rise among US teensthroughout the 1990s. Now, the latest Partnership
survey suggests that thistrend may have finally run out of steam.

The number of teens who said that they had tried marijuana in the past yearfell from 44% in 1997, to 42% in 1998,
to 41% in 1999. Just 21% of teensreported smoking pot in the month prior to the survey, down from 24% in1997.Marijuana
remains "the most widely used illicit drug among teens," accordingto the Partnership.

Six percent of young people polled said that they had sniffed or "huffed"inhalants, such as glue or solvents, at
least once in the past month, downfrom 8% in 1997 and 1998. Use of methamphetamine ("meth" or "crank") wasalsodown,
from 12% of teens in 1997 and 1998 to 10% in the most recent survey.

Teens appear more reluctant than ever to use cocaine and crack cocaine. "Forthe first time since 1993," the pollsters
report, "use of cocaine and crackhas shown a downturn." The number of teens who used cocaine in the monthprior to
the survey was 3%, and the number using crack was 2%, down from 5%and 3%, respectively, in 1998.

LSD use fell from 12% in 1998 to 10% in 1999. Experimental use of heroin andthe party drug Ecstasy "remained steady,"
the researchers say, at 3% and 7%.

Changes in teen attitudes appear to be driving recent antidrug trends.According to the pollsters, "Today, 40% of
teens strongly agree that 'reallycool' teens don't use drugs, compared to 35% who did just last year."

Even though more than half of teenagers reported being offered drugs at somepoint in 1999, they may also be finding
it easier to "just say no." Theauthors point out that "just 11% of teens today believe it's difficult toreject a friend's
invitation to try marijuana," down from 14% in 1998.

Movie and music idols appear to be losing their influence on teens when itcomes to drug use. According to the survey
authors, "Fewer teens believemusic makes marijuana seem cool, and fewer believe television and moviesglamorize drug
use."

The federal government launched a $195 million antidrug advertising campaignin 1998, which may have helped to spark
the trend away from drugs. But whileBurke believes that the campaign is "beginning to pay off," he cautions thatmuch
more work needs to be done.

Keeping the nation's teens off drugs "will require an unwavering commitmentfrom Congress and the administration,"
he said in a Partnership statement."Most importantly," he added, "it will require the intimate involvement ofparents."

More and More Trauma Victims Found Using Methamphetamine

Drug Implicated in Car, Motorcycle Accidents

By Elizabeth Tracey, MSWebMD Medical News

Dec. 9, 1999 (Baltimore) -- Methamphetamine, an illegal drug PresidentClinton's drug policy adviser has called "the
worst to hit America," isbeingfound in increasing numbers of people admitted to a trauma center inSacramento,
Calif., a situation health experts say is indicative of anationwide problem. The growing number of methamphetamine users
admitted tothe University of California, Davis is reported in the December issue of theJournal of the American College
of Surgery.

"We have seen methamphetamine positivity increase from 7.4% in 1989 to 13.4%in 1994," co-researcher David Wisner,
MD, tells WebMD. "The most commongroupof people using methamphetamines are Caucasians, followed by Hispanics."Wisner
is a trauma surgeon at the university.

The study examined data from a large number of people admitted to the traumacenter between 1989 and 1994, many of
whom underwent urine and blood testingto look for illegal drugs. In addition to methamphetamine, patients werescreened
for cocaine and alcohol.

Wisner says, "Methamphetamine was the most commonly found positive urinetoxicology result, followed by cocaine. Methamphetamine-positive
patientswere most commonly injured in motor vehicle and motorcycle crashes and weremore likely to need emergency surgery
than methamphetamine-negativepatients.They were also more likely to check out of the hospital against medicaladvice."

The number of methamphetamine users admitted for vehicular injuries wassimilar to the number of alcohol users involved
in crashes. Cocaine users,onthe other hand, were most commonly injured by assaults, gunshot wounds, orstab wounds.

During the study period there was a minimal increase in cocaine rates and adecrease in blood alcohol rates. The researchers
attribute this to thesuccess of intervention programs designed to decrease alcohol and cocaineuse. They suggest that
since methamphetamine-positive patients were injuredin similar ways to those of alcohol abusers, injury prevention programs
formethamphetamine should be patterned after strategies for alcohol.

Timothy Condon, PhD, the associate director of the National Institute onDrugAbuse, who commented on the study
for WebMD, agrees. He says, "I am notsurprised by the results of this study, and we're seeing methamphetaminemoveacross
the country. Right now there's a lot of methamphetamine use in theMidwest. On the East Coast it's still not as big as
crack cocaine, but it'smoving this way."

Both Wisner and Condon agree that what makes methamphetamine, also known as'crystal' and 'crank,' attractive is that
it is cheap and easily made. SaysCondon, "Methamphetamine use is increasing in rural areas of the country aswell,
and in these areas intervention programs have not been instituted, soit may present more of a problem."

Says Wisner, "Methamphetamine use may be associated with more motor vehicleaccidents because people who are using
the drug may take more risks. Theymayalso not be sleeping enough or they may be withdrawing from the drug, whichcan
produce fatigue, sleepiness, and depression. Methamphetamine use hasimportant public health consequences."

Vital Information:

The use of methamphetamine among trauma center patients is increasing,according to a study in one California community,
and public health expertssay the problem in growing nationwide.Patients who had used methamphetamine were more likely
to have been in a caror motorcycle accident, need emergency surgery, and check out of thehospitalagainst medial
advice.Researchers suggest that intervention programs similar to those used foralcohol be established for methamphetamine.

Associated Press Wire ServiceThursday, Dec 16

Domestic Violence Tied to AlcoholBy The Associated Press

Men who abuse alcohol and drugs tend to batter their wives and girlfriendsmore often than others, according to two
new studies in today's New EnglandJournal of Medicine.

Other factors tied to domestic violence include unemployment and a breakupof the couple, researchers said.

One domestic violence study at eight emergency departments around thecountry looked at 915 injured women, including
256 hurt by husbands or malepartners. The women were asked about the habits and lives of the men.

Another study analyzed the factors for both domestic and other violenceagainst women in west Philadelphia.

The first study found more than three times the risk of domestic violencewhen husbands or male partners abuse alcohol
or drugs, go in and out ofjobs, or break up with the women.

The Philadelphia study found a similar link between violence and cocaine.

Timothy O'Farrell, a psychologist at the Harvard Medical School who hasstudied the link between alcohol and battering,
said the latest studiesgenerally back up what was suspected and what other studies show.

But he said the two studies help show the need for more anti-violencetreatment for alcoholics and more alcoholism
treatment for violent men.

AP-NY-12-16-99 0430EST<

Top Drug Fighter Cites Need to Emphasize Treatment

Dollars Spent to Rehab Inmates Can Yield Big Gains, McCaffrey Says

By Jeff LevineWebMD Washington Bureau Chief

Dec. 13, 1999 (Washington) -- The road to rehabilitation and treatment is apath the Clinton administration wants
more addicts in the criminal justicesystem to follow, according to Gen. Barry McCaffrey, director of the WhiteHouse
Office on National Drug Control Policy. In remarks made last week to agroup of law enforcement and public health officials,
McCaffrey said it wastime to break "the tragic cycle of drugs and crime by reducing drugconsumption and recidivism
[relapsing into past behaviors]."

"Our dominant approach of primarily incarcerating drug offenders has been afailed social policy. We are now replacing
it with a common-sense approachoftreatment and testing combined with law enforcement," said McCaffrey.Currently,
about two-thirds of the nation's $18 billion anti-drug effort isspent on the enforcement side of the ledger.

While McCaffrey has been a constant advocate of treatment, sources in themedical community tell WebMD they hope his
comments will translate into moredollars diverted from punishment to rehabilitation. McCaffrey says he wantsto expand
treatment as an alternative to prison for nonviolent drugoffenders.

Drug rehabilitation specialists point out that treatment, ranging from about$2,000 to $7,000 per session, is a relative
bargain compared to prison,whichcosts about $25,000 per year. The Office of National Drug Control Policysaysits
research shows that recidivism rates go down substantially among thosewho get treatment before, during, or after going
to jail. It's estimatedthatup to 70% of untreated parolees who have a cocaine or heroin habit fall offthe wagon
within three months of release.

McCaffrey's statements bring the enforcement and medical communities closeron the drug issue, according to June Osborn,
MD, chairwoman of PhysicianLeadership on National Drug Policy. The group advocates treating addictionlike other chronic
diseases.

"Really, there is a great deal of room for positive effort to reduce thedrugproblem from the treatment side.
The common interest of the medical andjudicial/legal systems is very striking once you start looking at this, atthe
efficacy of drug treatment," Osborn tells WebMD.

She and other physicians met with McCaffrey last year to discuss ways toenhance substance abuse education efforts.
"The need to be allies issomething we feel very strongly about," says Osborn.

Although the man who headed drug prevention efforts during the Nixon andFordadministrations doesn't believe addicts
and their compulsions can be treatedlike diabetics or asthmatics, he praises McCaffrey's push for treatment."General
McCaffrey is the best friend treatment has had in that office for along time," psychiatrist Robert DuPont, MD, tells WebMD.
"He understands[treatment], and I think that is really something to be celebrated. I don'tthink the treatment community
grasps the fact that he is as enthusiastic ashe really is," says DuPont. DuPont endorses the idea of drug courts that,
ineffect, force addicts into treatment programs and send them back to jail ifthey don't stay clean. McCaffrey says
he also favors such efforts.

However, other doctors feel that public policy should move even farther awayfrom punishment when it comes to dealing
with certain drug crimes. "They[lawenforcement officials] would have to seriously rethink the current policy ofincarcerating
people for possessing small amounts of marijuana, because itseems to be to be a completely foolish practice," Jerome Kassirer,
MD,formereditor of The New England Journal of Medicine, tells WebMD.

WASHINGTON (AP) - Juvenile offenders are less likely to commit futurecrimes if they are put in rehabilitation programs
and heldaccountable for their behavior than if they are punished severely, acongressional advisory group said today.

In an annual report, the Coalition for Juvenile Justice said it is amistake to lock up juveniles at earlier ages
for a wider variety ofoffenses with inadequate therapy, drug treatment and otherrehabilitation.

``When centers that confine juveniles are safe, humane andrehabilitative, it's a win-win - both the public and childrenbenefit,''
said David Doi, executive director of the coalition.``Youthful offenders are not super-predators to be locked away andforgotten.''

Policy-makers who are pushing to increase punishment of youthfuloffenders ignore evidence that juvenile crime is
steadily decreasing,the report said. Violent juvenile crime hit its lowest level in adecade in 1998, and had dropped
30 percent since 1994, according tothe Justice Department.

However, though there is disagreement over why juvenile arrests arefalling, some say the trend is due in part to
stiffer sentences forrepeat violent offenders.

The group is a coalition of state juvenile justice advisory groupsthat were created by Congress to help states reduce
youth violenceand comply with federal requirements. The coalition has issued yearlyreports to Congress since 1986.

The new report, called ``Ain't No Place Anybody Would Want to Be,''looked at youth confinement in America by highlighting
the conditionsat four facilities:-The nation's first, and one of its largest, the Juvenile TemporaryDetention
Center in Chicago. The facility has made progress recentlyin screening out juveniles who don't need to be there, the reportsaid.

-The District of Columbia jail, an adult facility with few servicesfor the youth housed there.

-The Ferris School in Wilmington, Del., for which the state built anew facility and improved educational opportunities
as resolution fora lawsuit by the American Civil Liberties Union.

-The Giddings State Home and School in Texas, a well-equippedfacility that has seen low recidivism as a result of
rigorousrehabilitation programs, the report said.

Overall, about 120,000 juveniles are being held in custody each day,nearly 10 percent in adult facilities, the report
said. That numberhas soared 73 percent over the past decade, meaning that almostthree-fourths of youths are in overcrowded
facilities.

The average stay in detention is two weeks, while the average stay ina long-term facility is about five months. And
even though less thanone-third are incarcerated for violent crimes, most of those who havecommitted serious offenses
are released within a few years, thereport said.

``Without an education, without health care, without practicalskills, without transition steps back into their communities,
withoutprograms that have turned their antisocial activity into meaningfullife lessons, what chance do they have of
becoming productive,law-abiding citizens?'' the report said. ``What chance does societyhave of being safe?''

In its recommendations, the group urged Congress to encourage a focuson prevention and to alleviate overcrowding
by funding morefacilities as well as supporting incarceration alternatives. It alsoasked the administration to enforce
minimum federal standards forjuvenile facilities.

NEW YORK -- Combining blood tests with a statistical package may give physicians an objective measure of how much
drinking an alcoholic patient really does, Jim Harasymiw, Psy.D., reported at the annual meeting of the American Society
of Addiction Medicine.

Dr. Harasymiw of ARO/HS Counseling Centers in Big Bend, Wis., sought to use the Early Detection of Alcohol Consumption
(EDAC) score to detect problem drinking in young adults who presented themselves at the University of Missouri student
health service.

The EDAC panel uses a combination of 25 blood chemistry and hematology analytes processed with a linear discriminant
function.

Dr. Harasymiw recruited his 147 subjects not on the basis of a diagnosis of alcoholism but on how much they reported
drinking. Male heavy drinkers were defined as consuming four or more drinks a day, while women in the same category
consumed three or more drinks a day.

Of the 10 men who identified themselves as heavy drinkers, 8 (80%) were identified as such by the EDAC score. Forty-eight
of 54 (89%) men classified as light drinkers based on self report were correctly identified by EDAC. The remaining
six men reporting consumption of less than four drinks daily were classified as heavy drinkers by their EDAC score.

Among the women, the two self-reported heavy drinkers were correctly identified by EDAC. Of the 81 women who identified
themselves as light drinkers, 64 (79%) were so identified by EDAC. The remaining 17 women reporting average alcohol
consumption of less than three drinks a day were identified as heavy drinkers by EDAC, Dr. Harasymiw said.

Because the EDAC can be applied as much as 2-4 weeks after the subject has stopped drinking, it is more useful for
checking alcohol use than the familiar Breathalyzer test, he said. To simplify the procedure, Dr. Harasymiw is now
seeking to reduce the blood panel to 10 elements, making it more attractive for everyday use in doctors' offices.

"Then it can serve as a screening test to raise questions about the patient's alcohol risk profile or to monitor
abstinence," he said.

----Domestic Violence Tied to Alcohol

By The Associated Press

Men who abuse alcohol and drugs tend to batter their wives andgirlfriends more often than others, two studies show.

Other factors tied to domestic violence include unemployment and abreakup of the couple, according to the researchers.

The studies were published Thursday in the New England Journal of Medicine.

One domestic violence study at eight emergency departments around thecountry looked at 915 injured women, including
256 hurt by husbandsor male partners. The women were asked about the habits and lives ofthe men.

Another study analyzed the factors for both domestic and otherviolence against women in west Philadelphia.

The first study found more than three times the risk of domesticviolence when husbands or male partners abuse alcohol
or drugs, go inand out of jobs, or break up with the women.

``This study offers the strongest evidence so far that links alcoholabuse by the male partner with domestic violence,''
said Dr.Demetrios N. Kyriacou of Olive View-UCLA Medical Center, the leadresearcher.

The Philadelphia study found a similar link between violence and cocaine.

Timothy O'Farrell, a psychologist at the Harvard Medical School whohas studied the link between alcohol and battering,
said the lateststudies generally back up what was suspected and what other studiesshow.

But he said the two studies help show the need for more anti-violencetreatment for alcoholics and more alcoholism
treatment for violentmen.

---Friday December 17 6:28 PM ET

Teen Drug Use Falling, But Steroid, Ecstasy Use Up

By Melissa Bland

WASHINGTON (Reuters) - For the third straight year, overall illicitdrug use among U.S. teenagers declined or leveled
off in 1999, but anew federal study released on Friday showed increases in the use ofcertain drugs, including ``ecstasy''
and steroids.

The Department of Health and Human Services (HHS) and the NationalInstitute of Drug Abuse (NIDA) said in a joint
report that usage ofMDMA, or ``ecstasy,'' has increased among 10th and 12th graders,while lifetime steroid use among
10th graders nearly doubled thisyear and was also up among 8th graders.

The ``1999 Monitoring the Future'' study found overall use of illegaldrugs among teens remained level this year compared
with 1998, withdecreases noted in crack cocaine use among 8th and 10th graders andmethamphetamine use among 12th graders.
The use of alcohol andcigarettes was unchanged from last year in all three grade levels,the report said.

``So long as any of America's young people are at risk, we know thatour good news could be better,'' HHS Secretary
Donna Shalala told anews conference.

She said alcohol use ``remains at unacceptably high levels,'' addingthat while daily use of alcohol has decreased
among 12th graderssince 1998, ``the proportion of 10th graders who've been drunk overthe past year has actually grown.''

The survey, which has tracked teen drug use since 1975, was conductedby the University of Michigan's Institute for
Social Research andfunded by the federal government. The 1999 survey involved more than45,000 students in 433 schools
nationwide.

To combat drug abuse, NIDA is increasing funding for research on``ecstasy'' and other so-called club drugs by 40
percent. Theinstitute posts warnings on the dangers of these drugs on its Website, www.clubdrugs.org.

NIDA is also expanding its outreach into schools to further educateyouth, parents and teachers on the effects of
marijuana and otherdrugs.

Shalala said HHS, the Department of Education and other agenciesformed a joint ``Start Early, Start Smart'' initiative
to integratesubstance abuse and family services together.

She added that government programs will not work, however, if parentsare not involved, ``...without their leadership,
they will only bedoomed to fail.''

Arthur Dean, chairman and CEO of the Community of Anti-DrugCoalitions of America, a group of 5,000 community coalitions
fightingdrug abuse, also stressed the need for community involvement.

``If anything, this study demonstrates that we must shift resourcesto where they are being proven most effective
-- at the communitylevel where the problem lies, where the problem can be solved,'' Deansaid.

Most drug users lack access to treatmentNEW YORK, Dec 21 (Reuters Health) -- Drug-abuse treatment programscan
result in major reductions in drug use and related crime, butdespite these positive effects, most drug users do not receivetreatment,
researchers report. In fact, the number of treatmentprograms is declining.

According to Dr. Marjorie Gutman, of the University of Pennsylvaniain Philadelphia, and Dr. Richard Clayton, of the
University ofKentucky in Lexington, less than a quarter of drug users in theUnited States receives treatment for addiction.
During the lastdecade, not only has the number of drug-treatment programs declined,but also the quality of the treatment
has worsened, the researchersreport in the November/December issue of the American Journal ofHealth Prevention. Part
of the problem is that managed care healthplans often offer coverage for mental health through a separateorganization
than for physical health, they note.

Despite the declining availability of drug treatment, from 30% to 50%of drug users who undergo treatment are able
to stay off drugs,according to the report. While this number may seem low, Gutman andClayton point out that this rate
is similar to the percentage ofpeople with diabetes or asthma who keep their condition under control.

However, for two groups of people, those who abuse more than one drugand those who are mentally ill, there are few
drug treatment programsdesigned to meet their needs, according to the authors. Theresearchers also report that two
drug-related programs,needle-exchanges for injection drug users and treatment for drugaddicted pregnant women, are
the source of significant controversy.

On the prevention front, while some studies have shown thatschoolchildren enrolled in drug-education programs are
about half aslikely to use drugs as other kids, another study has found that DARE,a drug education program used by
more than half of all US schools,has little effect on drug use.

SOURCE:American Journal of Health Promotion 1999;14:92-97.

ALCOHOL ABUSE IS AN EXPENSIVE PROBLEM

December 22, 1999

Alcohol abuse costs society an estimated $250 billion per year in healthcare, public safety and social welfare expenditures,
according to a studybythe California Endowment (www.calendow.org) and researchers from theUniversity of Connecticut, Farmington (www.uconn.edu), the University ofWashington, Seattle (www.washington.edu) and the University of Kentucky,Lexington (www.uky.edu).

The study authors concluded that alcohol abuse will continue to beamajor health
problem until public understanding improves. The researchteam,led by Thomas Babor of the University of Connecticut,
analyzed alcoholabuseprevention and treatment programs. Though these programs have improved,about5 percent
of adults still abuse alcohol or are alcohol dependent,researcherssay. The study was published in the November/December
issue of theAmericanJournal of Health Promotion.

"Such problems persist in part because we view them as moralfailuresor disease,
rather than interactions among alcohol, drinkers and theirenvironments," Babor stated. "We need to focus on early identification,casemanagement
and organized systems of care that serve the health needs ofthecommunity."

Some types of individual treatments, such as 12-step programs andpharmacological agents,
were also found to be available and effective.However, insurance coverage limitations, shortage of health careprovidersand
perceived stigma of treatment act as barriers to wider use.

Solutions offered by the researchers include raising the drinkingage,higher taxes
on alcohol, restricted hours of sale, restrictions onadvertising and more societal disapproval of driving and drinking.

The team evaluated three levels of response to alcohol abuse andalcoholism. The first
was the development of treatment programs,includingformal treatments and group therapy. They found that these treatments
areeffective, said Babor, especially when combined with support from thecommunity, such as a 12-step program like
Alcoholics Anonymous(www.alcoholics-anonymous.org).

The second level of response involved interventions with people athighrisk for
alcohol abuse and alcoholism. The study authors found that newprograms in this arena have been developed, often in collaboration
withthemedical community. However, they also found that while simple approachestoalcohol abuse intervention
work, they are rarely implemented. Forexample,though controlled trials have shown that physician-delivered adviceeffectively
reduces the quantity and frequency of patient drinking,almosthalf of U.S. internists don't ask patients how much they
drink.

"Doctors are asked more and more to do preventive care," saidBabor,"including
everything from advice on exercise to diet to cigarettesmoking toalcohol." While some health plans support doctors
in this area, not alldo,and doctors are experiencing growing constraints on time to discuss suchhealth concerns
with patients.

Primary prevention represents the third area studied. According toBabor, these are
the easiest types of preventions to implement. Theyincludeenvironmental approaches, such as raising the legal drinking
age,reducingthe availability of alcohol through hours of sale, making alcohol morecostlyby increased taxes,
and increased societal disapproval of drunk drivers.Ofthe three areas looked at, primary prevention is the least costly
and hasthelargest impact, stated Babor.

"America has had an ambivalent relationship with alcohol for 200years," said Babor.
"Alcohol consumption has leveled off and decreased inrecent years." Yet, he continued, the problem is not solved simply
bytargeting drunk drivers or alcoholics. "It's everybody's responsibility,"heconcluded, "to cut back on their
drinking to manageable, moderatelevels."

American Journal of Health Promotion (1999;14;98-103)

School antismoking efforts may backfire

By E. J. Mundell

NEW YORK, Dec 27 (Reuters Health) -- Suspension or expulsion fromschool for smoking does little to curb the habit
among high schoolstudents and may even encourage it, researchers report.

``Given this possibility, it may make sense to rethink present(antismoking) policies and sanctions'' in secondary
schools, concludeDr. Ruth Saunders, Dr. Sarah Levin, and Maurice Martin of theUniversity of South Carolina. They publish
their findings in thecurrent issue of the journal Nicotine & Tobacco.

The authors point out that despite widespread media campaigns toutingthe dangers of smoking, one 1997 study found
that 39% of SouthCarolina 9th- through 12th-graders said they were smokers -- up 13%from 1991.

To find out what educators are doing to curb the problem, theinvestigators sent detailed questionnaires to principals
and healtheducators working in schools across the state.

``Over 95% of respondents reported having school policies thatprohibited use of tobacco inside buildings... (or)
anywhere on schoolgrounds,'' the authors report. Penalties for violation of these ruleswere ``severe.''

``For a second offense, nearly 68% of students are suspendedout-of-school or expelled, and for a third offense, almost
28% ofstudents are expelled,'' according to the researchers.

However, co-author Martin told Reuters Health that ``in spite of thestrong policies, adolescent smoking was becoming
steadily moreprevalent'' in South Carolina schools. He and his colleagues theorizethat ``by suspending and expelling
students who smoke, educators maybe perpetuating the tobacco use cycle that they desire to disrupt.''Suspension and
expulsion discourage high school graduation, and ``menand women with less than a high school education are more likely
tosmoke than those with more advanced education,'' the investigatorspoint out.

So what should schools do to curb teen smoking? According to theSouth Carolina team, administrators need to shift
away frompunishment and toward effective education aimed at both preventingteens from starting to smoke, and helping
those who do smoke to stop.

More than half the health educators surveyed said they had used theDARE (Drug Abuse Resistance Education) program
to try to preventsubstance abuse. However, as reported previously by Reuters Health,one recent 10-year study found
the DARE program ineffective inpreventing young people from using cigarettes, alcohol, and drugs.

There are effective alternatives to DARE, and the US Centers forDisease Control and Prevention currently recommend
'Life SkillsTraining' and T.N.T. ('Toward No Tobacco') as two ''Programs ThatWork.'' However, the study authors report
that ''only 10% of theschools reported using some or all'' of these programs in their fightagainst teen tobacco use.
``Fewer still offer tobacco cessationprogramming for violators of tobacco policy,'' they report.

Strategies that educate teens about the dangers of smoking may thebest means of preventing youngsters from 'lighting
up,' the expertsconclude. ``Smoking is not just a risk factor or deviant rebelliousbehavior,'' Martin said, ``it becomes
an illness, an addiction thatgrips young people threatens their lives. We need to try to worktoward treating the problem
as well as preventing it.''

SOURCE: Nicotine & Tobacco 1999;1.

Study: Kids Exposed To Alcoholism

December 31, 1999WASHINGTON (AP) - About one in four U.S. children is exposed to familyalcoholism or alcohol
abuse while growing up, says a government studypublished Thursday.

The National Institutes of Health says the data, reported in January'sissueof the American Journal of Public
Health, provide the best estimate yetofchildren living with a parent or other adult who has an alcohol problem.

"It adds another dimension to the size of the alcohol problem in thiscountry," said Dr. Enoch Gordis, director of
NIH's National Institute onAlcohol Abuse and Alcoholism. "Aside from developing alcohol problemsthemselves, these
kids often have conduct disorders, some have emotionaldisturbances, some do badly in school."

The findings stem from a new analysis of a 1992 federal survey of 42,800Americans, the latest data available. Gordis
said the information isvaliddespite the survey's age because alcoholism rates have held steady overthelast
decade.

There are an estimated 14 million American alcoholics. Alcoholism iscausedby a mix of genetic and environmental
factors, and previous studies showthechildren of alcoholics are themselves at increased risk, Gordis said.

The new analysis concludes about 10 million children were exposed tofamilialalcohol problems in 1992 alone, and
more than 28 million children livedwithadults who at some point in their lives had abused or been dependent onalcohol.

Study author Bridget Grant, an NIH epidemiologist, concluded thatchildren'sactual exposure fell between those
two extremes, and thus estimated thatonein four children is exposed to familial alcohol abuse before age 18.

LONDON, Jan 10 (Reuters) - Axis-Shield Plc, the Dundee, Scotland-baseddiagnostics firm formed through last year's
merger of Axis Biochemicals withShield Diagnostics, said on Friday that it has received marketing approvalfrom the
US Food and Drug Administration for a new test to identify alcoholabuse.The product, known as %CDT, will identify
symptoms of alcohol abuse morequickly than other products, the company said in a statement. It measures theblood level
of carbohydrate-deficient transferrin, which rises aftercontinuous consumption of alcohol.

The %CDT test will be marketed in the US by pharmaceutical companies BioRadand Roche Diagnostics. The market potential
for %CDT is thought to besignificant in the US, since it is estimated that about 10% of the populationhas alcohol-related
problems, Axis-Shield said.

"We are very pleased to receive FDA approval which will enable us to plan theUS commercialization of %CDT. We believe
this market has the potential forsubstantial sales growth," Svein Lien, Axis-Shield managing director, said ina statement.

Shares in Axis-Shield rose 35 pence to close at 587.50 pence on the LondonStock Exchange.

Too much alcohol can cause you to get sick by weakening your body'sdefenses.

A new study reports that long-term alcohol consumption can harm thebody's ability to respond to stressors like illness
or injury.

Using rats, researchers led by Catherine Rivier, professor at theClayton Foundation Laboratories for Peptide Biology
at the SalkInstitute in La Jolla, Calif., examined the effects of alcohol on thestress response. One group of rats
was exposed to alcohol vapors, whileanother, normal population of rats served as a control group.

The rats were exposed to alcohol vapors for six hours a day for eightdays. All of the rats were then exposed to two
types of stressors - anelectric shock and injection of a toxin - and their hormonal levels wereobserved.

The stress response, also known as the "fight-or-flight" reaction, isinitiated in a region of the brain called the
hypothalamus, which isseated deep in the center of the brain.

When the body is exposed to a stressor, the hypothalamus releaseshormones called corticotropin-releasing factor (CRF)
and vasopressin(VP). These two hormones make their way to the pituitary gland, causingthe secretion of adrenocorticotropin
(ACTH). ACTH then goes into thebloodstream and causes the adrenal glands to produce corticosteroids.These chemicals
cause the redirection of nutrients, like glucose, to theareas of the body that are under stress.

"The purpose [of the hormones] is to find a way to maintain bodyhomeostasis, which allows for normal body function,"
said Dipak Sarkar,professor and chair of the department of animal sciences at Rutgers, TheState University of New
Jersey, in New Brunswick. "If this stresscontinues, however, it can cause a lot of problems."

The scientists found that in the control rats, hormone levels remainednormal and as expected. However, in the alcohol
group, levels of CRF andVP and cellular response in the hypothalamus were greatly decreased.

If CRF levels are low, one's responses to stress will probably not beadequate during periods of stress, Rivier said.
"CRF is absolutelycentral to our stress response," she added.

The study can be found in the January issue of Alcoholism: Clinical andExperimental Research.

Based on data from human studies and other past studies, Rivier knewthat alcohol, like other stressors, stimulated
thehypothalamus-pituitary-adrenal axis. "If the axis has been stimulated byone stressor, its response to others will
be altered," she noted.

"Stress can bring on sickness by altering the body's immune function, aswhen students get sick during an exam or
when people have a death in thefamily," Sarkar said. Chronic stress may result in a depressed immunesystem or even
growth suppression.

Rivier has received funding from the National Institutes of Health forseveral years for separate research on alcohol
and stress. For thisstudy, she simply put those two fields together.

Rivier noted that she would like to perform related research onalcohol-preferring rats, rats that drink alcohol voluntarily.
Paststudies have shown differences in the brains of rats who drank alcoholvoluntarily and those who, like the rats
in this study, were givenalcohol without a choice.

"Most of what we and others have found regarding the consequences ofalcohol have been found to occur in humans too,"
Rivier remarked.

Alcoholism: Clinical and Experimental Research (2000;24)

Drug Rehab Cuts Prison Recidivism

Study says in-and-out treatments effective

By Robert PreidtHealthSCOUT Reporter

SATURDAY, Jan. 15 (HealthSCOUT) -- Felons who participate in drugprograms in prison and then continue treatment after
release are lesslikely to end up as inmates again, new research shows.

Three separate studies of 1,461 prisoners in California, Texas andDelaware found that the combination of in-prison
and aftercare drugprograms dramatically cuts recidivism.

"The focus is on changing their thinking and behavior and constantpressure to conform to a pro-social way of living.
So it's not justaddressing the drug-abuse issue, it's also addressing a variety ofother pro-social needs like employment,
living arrangements and thatsort of thing," says Kevin Knight, a research scientist at theInstitute of Behavioral
Research at Texas Christian University inFort Worth.

Knight was a researcher on the Texas study which found that only 26percent of 282 inmates who completed in-prison
and communityaftercare programs had returned to prison after three years.

In comparison, 66 percent of those who dropped out aftercare programsand 52 percent of those who received no formal
treatment in prisonwere back in prison within three years.

The California study, by the Center for Therapeutic CommunityResearch at the National Development and Research Institutes,
Inc. inNew York City, showed only 27 percent of 162 felons who participatedin both programs were back in prison after
three years, compared with75 percent of 189 inmates who received no treatment.

University of Delaware researchers said only 31 percent of inmateswho completed the prison-and-community treatments
ended up back inprison, compared with 95 percent of those who had no treatment, 83percent of those who dropped out
of the program while in prison, and73 percent of those who finished the prison treatment but receivednone after release.

Combined, the three studies found an overall recidivism rate of 82percent among prisoners who dropped out of treatment
programs and a79 percent rate for prisoners who received treatment in prison butgot no follow-up care.

The findings were published in the December 1999 issue of The Prison Journal.

Approximately 1.8 million people are in prison in the United States,and about 65 percent of them have a history of
drug use, according tothe U.S Department of Justice. Fewer than 15 percent receive any formof systematic counseling
or intensive treatment for their drugproblem, the department says.

Yet he says it's a cost effective way to reduce drug addiction and crime.

"The bottom line, as far as I'm concerned, is these fellows aresitting in prison anyway so you're not incurring extra
costs forliving arrangements. You're essentially just providing therapeuticservices to help them get over their addiction.
And if you don't, weknow historically there's an extremely high percentage who are goingto re-offend within three
years of leaving prison if they don't getthe services," Knight says.

Drug rehabilitation programs for inmates do help, but they're not amagic wand, says Craig T. Love, a research associate
in theDepartment of Community Health at Brown University in Providence,R.I., and principal investigator for an evaluation
of the costeffectiveness of drug treatment programs in prisons.

Love says such treatment is a last resort, that what's needed is moremoney for community prevention programs to deter
young people frombecoming involved in drugs and crime in the first place.

"That's where I would put the emphasis," Love says.

ural Teens More Likely to Use Drugs Than Those in Big Cities

'Meth Has Come to Main Street,' Researcher Says

By the Associated
Press

Jan. 26, 2000 (Washington) -- Illegal drug use among adolescents insmall-town and rural America is reaching alarming
proportions, according toa private study released Wednesday that urges the government to spend asmuch money fighting
drugs in nonmetropolitan areas as it does in foreignbattlegrounds such as Colombia.

Eighth-graders in rural America are 104% more likely than those in urbancenters to use amphetamines, including methamphetamines,
and 50% more likelyto use cocaine, according to the study by the National Center on Addictionand Substance Abuse at
Columbia University in New York.

Also, eighth-graders in rural areas are 83% more likely to use crackcocaine, and 34% likelier to smoke marijuana
than eighth-graders in urbancenters, the study said. It was released at the U.S. Conference of Mayorswinter meeting
in Washington.

"Bluntly put, meth has come to Main Street, along with other drugs and withmagnum force aimed at our children, said
Joseph A. Califano Jr., presidentof the research group. "It's time for all Americans to recognize that drugsare not
only an urban problem."

To help counter the trend, Califano called on the Clinton administration andCongress to adopt a $1.6 billion "emergency
aid" package to help fundanti-drug efforts in rural America. On Tuesday, Clinton proposed a 2-year,$1.6 billion aid
package to Colombia, in part to assist with anti-drugefforts there.

Clinton and Congress must match "dollar for dollar aid to Colombia with aidto the rural communities," Califano said.

Califano's group used five different sets of data, from public and privateanti-drug organizations, to come up with
their results, and also studieddata from state and local law enforcement agencies. Each data set definedbig cities
and urban centers in different ways, but in general, theyclassified rural areas as those with populations of 10,000 or
less.

This Is Your Brain On Drugs...And Sex And Food January 28, 2000

BRECKENRIDGE, CO (Reuters Health) â€” Food, sex, and illicit drugs appear to share brain pathways that
spell "reward," which may explain why it is possible to become addicted to these things. At the 33rd annual Winter Conference
on Brain Research, a panel of experts discussed animal studies that show "a degree of interchangeability between eating
food, engaging in mating, and self-administering drugs."

Carroll's research showed that monkeys on food-restrictive diets use more cocaine than monkeys given ample food.
Giving monkeys glucose solution instead of plain water also reduces their cocaine use. Relapse after withdrawal is
greater in food-restricted animals. She concluded that in animals, food and sweets decrease first-time drug use by 40%
to 50%.

"We're trying very hard to find medications that help in drug addiction," said Carroll. "Some medications work a
little, but none work very well. A combination of food and medication decreases drug use 80% to 90% in animals. Medicine
combined with other rewards works best in humans."

Dr. Philippe DeWitte of the University of Lourain in Belgium studied the effect of exercise on alcohol use. A substance
called taurine, which regulates calcium efflux and influx, increases after running. Runners have higher levels of
taurine after a marathon or a 100-kilometer run.

"Heavily alcoholized rats have increased taurine," said DeWitte. "As do extreme runners. We can use aerobic exercise
to increase taurine and reduce alcohol use," he added.

Dr. Elaine Hull, from the State University of New York at Buffalo, has studied the effect of the neurotransmitters
dopamine and serotonin on sexual behavior in male rats. Her research shows that dopamine facilitates and serotonin
inhibits sex in male rats. She noted that studies in humans show that drugs that affect serotonin levels also affect sexual
function. "Anti-depressants like Prozac or Zoloft cause a decrease in libido and the ability to have orgasms," Hull
pointed out. "It's a side effect of serotonin."

Dr. Sara Leibowitz of the Rockefeller University studied the effect of the peptide galanin on fat intake. "There
is a positive feedback loop," she said. "Galanin shifts our preference to more fat intake. A high-fat diet in turn stimulates
galanin release."

"If we found a small molecule to bind the galanin active site, then we could reduce fat intake," Leibowitz added.
"In women at puberty, a high-fat diet stimulates estrogen and progesterone production. These steroids in turn stimulate
galanin release, which then stimulate more steroids."

Understanding the similarities and the differences involved in the pathways of the brain that control eating, mating
and drug taking will help in the development of therapies aimed at treating different types of addiction, the panel
concluded.

Copyright 2000 Reuters Limited.Number of Women Behind Bars SkyrocketsWASHINGTON (APBnews.com) -- The number
of women behind bars has exploded in the past 20 years, resulting in female inmates incarcerated far from their children,
in prisons where AIDS is rampant and drug-treatment programs are inadequate, a recent government report found.

Men still vastly outnumber women in prison by about 15 to one. But in the past two decades, the number of female
inmates has increased by more than 500 percent, from 13,400 inmates in 1980 to 84,000 by 1998, the most recent year
for which data is available, according to the study released Monday by the General Accounting Office, Congress' research
arm.

The passage of tough new laws on drug offenders played a large part in the increase, the study suggested. Drug sentences
accounted for most of the increase since 1990, with the number of female inmates serving time for drug offenses nearly
doubling.

Critics of these laws, including Washington, D.C., Rep. Eleanor Holmes Norton, who commissioned the study, say these
female inmates all too frequently got tangled up in drug operations as couriers or other low-level functionaries with
little information to offer prosecutors that could result in a lighter sentence.

"They have to take responsibility for that," Norton said. "They are often living off the fruits of drugs, using that
money to feed their habits, and they got caught. But they are very different from men, who grow up in the streets,
in the drug culture, who graduated into becoming dealers, and essentially take that as their life's work. That's not
how little girls get into crime."

More women have HIV than men

The study also found that women suffered considerably more than men inside the nation's penitentiaries. Women in
prison are more likely to suffer from AIDS and mental illness than male inmates, and to live greater distances from
their families than men.

The report relied on national data from the U.S. Department of Justice and studies of California, Texas and federal
prisons. The three jurisdictions together account for a third of all American prisoners.

According to the report, about 3.5 percent of female inmates in state prisons were infected with HIV, the virus that
causes AIDS, compared with about 2.2 percent of male inmates.

About 24 percent of female inmates in federal prisons and 24 percent of women in state prisons reported suffering
from mental illnesses, compared with 16 percent of male federal inmates and 16 percent of male state inmates.

Women are 'victims of men'

Norton said she suspects that many of these HIV-positive women in jail caught the virus from their drug-addicted,
drug-dealing boyfriends who drew them into crime.

"This points to a pattern -- women as victims eventually ending up in crime [as] victims of men," Norton said. "The
500 percent increase was more than what the prison systems were prepared for. They may have been prepared for the
effects of the mandatory minimums and repeat offender provisions for men, but I don't think they foresaw how these
provisions would have accelerated the rates of women in prison."

About two-thirds of female inmates had children under 18 waiting for them at home. Another 1,400 babies were delivered
in prisons in 1998. But a greater number of women than men, 30 percent vs. 24 percent, live more than 500 miles from
their families.

"Most data suggests that most women don't even see their children at all while they're locked up," said Ann Jacobs,
the executive director of the Women's Prison Association, a New York-based group that provides social services to
female inmates and their families. "But we know that frequency of contact has the most to do with the kids' well-being
and the ability of the family to reunify when the woman gets out."

More drug addicts, less treatment

In Texas, California and the federal system, drug treatment has been expanded in recent years. But waiting lists
for treatment still exist in all three jurisdictions. One prisoner rights advocate said community drug treatment instead
of prison-based treatment would be more effective and less damaging to families.

"If we were to create an integrated intervention, where women were provided with residential services, with an emphasis
on family preservation, drug treatment and then welfare-to-work programs, in two years, you could have families that
are much better functioning, with women who could support their kids," Jacobs said.

But for women in prison, this sort of drug treatment is growing more rare by the day. While the number of women in
prison who say they've used drugs regularly has increased, the number of women in prison receiving treatment has fallen.

From 1991 to 1997, the number of female federal inmates who admitted to regular drug use before incarceration
rose from 35 percent to 47 percent. In state prisons, that number rose from 65 percent to 73 percent. But the number
of women who say they've had drug treatment in federal prisons fell from 19 percent to 10 percent in federal prisons
and from 29 percent to 15 percent in state prisons.

Texas: We try to keep women near family

But corrections officials in Texas faulted the study for only examining three prison systems. Responding to the criticisms
in the report, a spokesman said the Texas prison system had built an effective drug treatment system virtually from
the ground up since 1993.

Regarding the distance of female inmates from their families, California Department of Corrections spokeswoman Margot
Bach said families of male inmates frequently move closer to the prison, while female inmates usually leave their
children behind with grandparents or foster parents.

Furthermore, the distance of female prisoners from their families represents the inevitable result of small budgets